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Cardiac Anomalies - is something going on or is this normal?

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van Hooydonck wonders about his illnes and racing -

https://cyclinguptodate.com/cycling...ned-too-hard-ive-always-asked-a-lot-of-myself

“My right ventricle is too big. This caused a cardiac arrhythmia. In December there was nothing to see during a check, but it has deteriorated quickly," van Hooydonck reveals in an interview with NOS. The Dutchman says that he had a heart test months before the incident and nothing was shown. Hence he believes that throughout the year he developed problems. "Maybe I trained too hard? I've always asked a lot of myself, but I don't think that's the reason.”
On the 12th of September the former Jumbo-Visma rider suffered a heart attack whilst driving his car and had an accident subsequently. He was resuscitated on scene and luckily managed to move on from the situation and is currently living a very different life. He's thankful for it, and he now also puts the topic on the table of whether he was a victim of a different type of racing that takes place in modern times.

“The finals are opened earlier. While we used to ride two hours on the limit, it is now three hours. In sometimes grueling circumstances, that is not healthy," he argues. Similar cases to his have been happening far too often in recent years, the most notable of which Sonny Colbrelli last spring who retired whilst being the reigning European Champion and Paris-Roubaix winner. "It's hard to say whether it has anything to do with that. It is striking that there are more cases now that the way of racing has changed.”
 
The problem with basing an 'opinion' on key-word searches is that you tend to just ignore the inconvenient evidence contradicting the line you're seeking to trot out.
This is a key point: we are usually looking for affirmation not information, and we want the easiest 'evidence' to understand.

I think that I have posted this already in the thread, but its important to note that cardiac irregularities exist in the entire population. The difference being that a cubicle working, couch dwelling human might not push that irregularity until they are old enough that people just accept it as a an age thing, plus we don't read about their deaths.*

*I read research from one of the large USA cities that identified deaths by type and age, and remember being shocked by how many people in their 40s die of heart issues. Heart disease is the leading cause of death worldwide, some of that is congenital, and some of that is lifestyle (increasing) obviously.
 
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If folk are to be believed, cycling - racing - is inherently unhealthy.

Did Hippocrates really say that "The athletic development is not natural; much better the ordinary healthy condition of the body”? Who cares! It's too good not to be true!

We haven't quite had anyone saying that a good Tour takes a year off your life, a bad one more (Philippa York was full of crap science even pre-transition and credulous hacks hanging on to her every word) but we're getting there, with the claim that riders are looking 10 years older than their real age.

The problem with this bullcrap is that, as usual, the evidence does not back it up.

Sanchis-Gomar et al's 2011 paper Increased average longevity among the "Tour de France" cyclists doesn't support this pet theory beloved by some ("Our major finding is that repeated very intense exercise prolongs life span in well trained practitioners").

Marijon et al's 2013 paper Mortality of French participants in the Tour de France (1947-2012) doesn't support this pet theory beloved by some ("We observed a substantially and significantly lower mortality in participants in the Tour de France, compared with the general male population.").

Davison's 2021 paper Tour de France 'yellow jersey' wearers live significantly longer doesn't support this pet theory beloved by some ("these and other results now seem to challenge the common belief that large lifetime volumes of exercise could be harmful to health and thus longevity.").

But, yeah, despite the evidence, all that cycling that cyclists do, of course it's the problem. Has to be, people with heart problems say it, and they're the experts in this stuff.
The reality of study groups that focus on Tour riders is that almost none of the research would include the comprehensive lists of undisclosed dietary and supplemental aids. It's no secret that hormone manipulation has led to increases in early cancer for women, for example. The entire East German Olympic training model exposed the fate that most of their unaware lab test athletes suffered. What Tour level riders are willing to do regarding diet, drugs is Phillapa's world, I would guess.
 
van Hooydonck wonders about his illnes and racing -

https://cyclinguptodate.com/cycling...ned-too-hard-ive-always-asked-a-lot-of-myself

“My right ventricle is too big. This caused a cardiac arrhythmia. In December there was nothing to see during a check, but it has deteriorated quickly," van Hooydonck reveals in an interview with NOS. The Dutchman says that he had a heart test months before the incident and nothing was shown. Hence he believes that throughout the year he developed problems. "Maybe I trained too hard? I've always asked a lot of myself, but I don't think that's the reason.”
On the 12th of September the former Jumbo-Visma rider suffered a heart attack whilst driving his car and had an accident subsequently. He was resuscitated on scene and luckily managed to move on from the situation and is currently living a very different life. He's thankful for it, and he now also puts the topic on the table of whether he was a victim of a different type of racing that takes place in modern times.

“The finals are opened earlier. While we used to ride two hours on the limit, it is now three hours. In sometimes grueling circumstances, that is not healthy," he argues. Similar cases to his have been happening far too often in recent years, the most notable of which Sonny Colbrelli last spring who retired whilst being the reigning European Champion and Paris-Roubaix winner. "It's hard to say whether it has anything to do with that. It is striking that there are more cases now that the way of racing has changed.”
So cardiac testing showed “normal” and then 3 months later (over the course of the cycling season) he has a heart attack and shows some heart abnormalities. I know this CN group understands this, but still worth saying: the 1st thing to find out (to have any kind of useful discussion) is how often does the same thing occur in the generally healthy but non-pro cycling population?
 
I think that I have posted this already in the thread, but its important to note that cardiac irregularities exist in the entire population.
This is very important.

One of the reasons this thread exists was to ask "Do we have a problem?" I don't think the evidence - pre-Covid - supports a yes answer to that. But people are offering explanations as if it does.
 
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Duh, those studies are looking at mortality. Not causes of death. And what they're all showing is the assumptions are out of whack with the evidence.
Duh...and mortality data from 80's-00's would be irrelevant to compare to different eras of training/racing is my point. Alledgedly cleaner current day riders seem to be the media focus as they develop problems and they operate in the bio-passport era.
 
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Duh...and mortality data from 80's-00's would be irrelevant to compare to different eras of training/racing is my point. Alledgedly cleaner current day riders seem to be the media focus as they develop problems and they operate in the bio-passport era.
Respectively disagree.. A few posts up, Dirt points out his surprise at death in people in their 40s. 1980-2000 may not be full of surprises, but the data set in 2023 could be inclusive of DNA history showing that your grandmother if not cooking, cleaning, getting dinner ready, get kids ready for school or bed, being a homemaker could have won the TDF..or she may have tipped over dead if she did something w high heart for a couple of years. Doping may be an issue but underlying genetics I would guess are majority of the criteria for great athletic heights or premature death. There may exist some data from 1980 that could be expanded using technology to show that many pro riders were at great risk. I don't think that all old data is useless. In 1980 did they give you an EKG, VO2 max as part of a typical battery of tests ..nah..
What everyone should be scared of is big data..at home computer test telling you that you will never be an athlete, play the piano, get cancer, become a drug addict, get dementia, on what we could find out sure it may be helpful but it would have certainly had me not swing my legs over a Briggs and Stratton mini bike before 5 years old. I will not be surprised to find out that I am genetically predisposed to eating smoked fish, wood fired pizza and cheese..cheesecake. It won't be long for technician to tell new parents.. Your kid is going to be fat,gay,alcoholic.. who knows ..would I have not raced bikes if someone told me that I had a bad heart? Think not.
 
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He doesn’t say what kind of test, and even if he did the specific details (ultrasound? PET scan, simple EKG) might get lost in translation. But he suggests that the recent tests after the heart attack shows an enlarged ventricle and he had some reason to think/suggest that it was not in that condition previously, because they couldn’t “see” a problem previously.
“My right ventricle is too big. This caused a cardiac arrhythmia. In December there was nothing to see during a check, but it has deteriorated quickly," van Hooydonck reveals.”
 
He doesn’t say what kind of test, and even if he did the specific details (ultrasound? PET scan, simple EKG) might get lost in translation. But he suggests that the recent tests after the heart attack shows an enlarged ventricle and he had some reason to think/suggest that it was not in that condition previously, because they couldn’t “see” a problem previously.
“My right ventricle is too big. This caused a cardiac arrhythmia. In December there was nothing to see during a check, but it has deteriorated quickly," van Hooydonck reveals.”
What he said was they do tests annually in December and indeed nothing was visible on them. The specialist at the hospital asked for the previous ultrasounds (or whatever they were) and they concluded the same. Yes, a large heart, but not out of the ordinary for a professional athlete. However since the last test in December his right ventricle increased in size significantly.

I think perhaps someone of Van Hooydonck's physique has to ask too much of himself to be the helper in the mountains he was these past two Tours. Or indeed it's the difference in racing style of the last couple of years as he has suggested. Or it's none of these things and pure bad luck.
 
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He doesn’t say what kind of test, and even if he did the specific details (ultrasound? PET scan, simple EKG) might get lost in translation. But he suggests that the recent tests after the heart attack shows an enlarged ventricle and he had some reason to think/suggest that it was not in that condition previously, because they couldn’t “see” a problem previously.
“My right ventricle is too big. This caused a cardiac arrhythmia. In December there was nothing to see during a check, but it has deteriorated quickly," van Hooydonck reveals.”
Barring something abnormal, a ventricle doesn't enlarge that quickly (EDIT: especially for no reason). Right ventricle issues are usually related to pulmonary complications (if it isn't directly related to cardiac abnormalities).

DISCLAIMER: Let me be clear, I am not a doc, let alone a cardiac specialist.
 
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But he suggests that the recent tests after the heart attack shows an enlarged ventricle and he had some reason to think/suggest that it was not in that condition previously, because they couldn’t “see” a problem previously.
Nothing he says suggest he understands the difference between a test and a test, everything suggests he sees it the same way many here do, a test is a test is a test. It's not.

At WT level, the UCI's rules require three groups of tests: biannual, annual and quarterly.

The biannual (two-yearly) covers the following:

a cardiological examination including:
− a doppler echocardiography
− or a stress electrocardiogram.
− These examinations must be done alternately (one year doppler echocardiography, one year stress-electrocardiogram

The annual covers:

Every year, during the period from 1st December to 31st January (first period), riders must have completed the following exams:
− A cardiovascular risk questionnaire
− A rest electrocardiogram (12 leads).
− For the riders who suffer from asthma or exercise-induced bronchoconstriction (EIB), an annual pulmonary function testing will have to be done.
− A visual acuity test.
− An urinary stick.

The quarterly tests are basically blood work.

Teams can test for more, if they wish, these are the minimums. None of these would spot an enlarged ventricle. More comprehensive testing might, if you set out to look for it in the first place.
 
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Nothing he says suggest he understands the difference between a test and a test, everything suggests he sees it the same way many here do, a test is a test is a test. It's not.

At WT level, the UCI's rules require three groups of tests: biannual, annual and quarterly.

The biannual (two-yearly) covers the following:



The annual covers:



The quarterly tests are basically blood work.

Teams can test for more, if they wish, these are the minimums. None of these would spot an enlarged ventricle. More comprehensive testing might, if you set out to look for it in the first place.
That’s helpful to know. So if I understand correctly you’re suggesting that the cardiac “check” (the term he used as quoted in the article) the previous Dec probably wasn’t the sophistication that would reveal the type of heart problems they subsequently found when they conducted a larger battery of tests that (of course) they would do after someone has a heart attack? That certainly seems possible or even likely to be the case.

In a probably not-useful pedantic side note, it’s interesting whether the translation of the verb “see” accurately represents what he said in his language. In English, the verb is used figuratively and literally. It can mean tangible visual observation or just a general understanding of something. When he said “there was nothing to see” in prior testing he probably meant the latter form.
 
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Barring something abnormal, a ventricle doesn't enlarge that quickly (EDIT: especially for no reason). Right ventricle issues are usually related to pulmonary complications (if it isn't directly related to cardiac abnormalities).

DISCLAIMER: Let me be clear, I am not a doc, let alone a cardiac specialist.

I have a severely enlarged right ventricle and will be undergoing closure of an atrial septal defect in December. Obviously I have had the defect for my entire life but only started having noticeable symptoms (ones that I couldn't dismiss as being from aging) within the last year or so - the ASD was discovered about two years ago. Since I was not symptomatic when this was discovered my DR's and I have been going slowly.

Just like you, I am not a cardiologist but VH's story, if not being muddied in translation seems very hard to accept as true.
 
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I have a severely enlarged right ventricle and will be undergoing closure of an atrial septal defect in December. Obviously I have had the defect for my entire life but only started having noticeable symptoms (ones that I couldn't dismiss as being from aging) within the last year or so - the ASD was discovered about two years ago. Since I was not symptomatic when this was discovered my DR's and I have been going slowly.

Just like you, I am not a cardiologist but VH's story, if not being muddied in translation seems very hard to accept as true.
Sorry to hear that, hope the procedure is effective.
 
I have a severely enlarged right ventricle and will be undergoing closure of an atrial septal defect in December. Obviously I have had the defect for my entire life but only started having noticeable symptoms (ones that I couldn't dismiss as being from aging) within the last year or so - the ASD was discovered about two years ago. Since I was not symptomatic when this was discovered my DR's and I have been going slowly.

Just like you, I am not a cardiologist but VH's story, if not being muddied in translation seems very hard to accept as true.
You are going to feel better than ever after that procedure! Keep us posted (maybe not here in the clinic though).
 
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