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Kirchen has heart attack

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Jun 21, 2010
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tgsgirl said:
Cynicism.



stupid limit stopping me from being succint

A more positive approach may be to assume innocence until evidence suggests otherwise. Somewhere a clean rider is achieving strong results - I would argue they should be honored and recognized with this assumption of innocence. Eventually, the cheats will be caught and punished in the public square. Why jump the gun?
 
Feb 18, 2010
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warmfuzzies said:
A more positive approach may be to assume innocence until evidence suggests otherwise. Somewhere a clean rider is achieving strong results - I would argue they should be honored and recognized with this assumption of innocence. Eventually, the cheats will be caught and punished in the public square. Why jump the gun?

Welcome to CyclingNews. You'll get used to it, unfortunately.
 
Apr 11, 2009
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There's ample precedent for riders having congenital and other latent heart defects, discovered or undiscovered. Lots of names have been mentioned here.

Riders are NOT abnormally healthy; they are abnormally fit. Big difference. A priori, they should fit the normal distribution of genetically induced health problems (the heart included), irrespective of whether they doped or not.

Fitness and health are correlated, but they are very definitely not identical. Someone with a latent/ genetically or biologically induced heart problem is going to have a heart problem irrespective of whether they doped.

Your heart can fail from a virus attacking the heart. Has nothing to do with the person's fitness or drug use.
 
Jun 20, 2010
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Arrythmogenic right ventricle cardiomyopathy has a molecular/genetic basis, causing the architecture of the muscle cells of the heart to be disrupted - this condition may be more commen in trained athletes than in the overall population, because the increased mechanical stress on the muscle fibers may facilitate the tearing apart of the muscle cells.

The condition can be difficult to diagnose, typically requiring evaluation of ECG changes, late depolarisations in signal averaged ECGs, continouos ECG monitoring, echocardiograms, cardiac MRI, heart muscle biopsies - and is greatly aided if there is a family history of similar disease. Genetic testing may be helpful sometimes.

ARVC would be my first guess of what has causes Kirchens cardiac arrest. Good to hear that he has woken up, after the anaesthesia has been stopped.
 
Jun 22, 2010
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ulrikmm said:
Arrythmogenic right ventricle cardiomyopathy has a molecular/genetic basis, causing the architecture of the muscle cells of the heart to be disrupted - this condition may be more commen in trained athletes than in the overall population, because the increased mechanical stress on the muscle fibers may facilitate the tearing apart of the muscle cells.

The condition can be difficult to diagnose, typically requiring evaluation of ECG changes, late depolarisations in signal averaged ECGs, continouos ECG monitoring, echocardiograms, cardiac MRI, heart muscle biopsies - and is greatly aided if there is a family history of similar disease. Genetic testing may be helpful sometimes.

ARVC would be my first guess of what has causes Kirchens cardiac arrest. Good to hear that he has woken up, after the anaesthesia has been stopped.

But I read that his EF (ejection fraction) was only 15% (normal 60%) which implies left heart failure not just RV failure;but all of this is speculation since none of us have access to his medical records
 
Jun 20, 2010
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2 comments:

Of course he did not ride TdS with an left ventricular EF of 15% = 25% of the normal heart function. Such patients would have heavy breathing, trying to walk uphill. The low EF can be the result of a prolonged cardiac arrest - which he probably had, given that hypothermia was necessary afterwards.

Actually, ARVC is not only a right ventricle condition. An understanding is beginning to emerge, that this condition frequently involves both ventricles (= pumping chambers), and sometimes primarily the left ventricle. We know this, because families exist, where patients with all three types of conditions exist, and all have the same ARVC gene defect.

Very rarely, we see patients with normal coronary arteries and acutely reduced left ventricular AF. Eg. the broken heart syndrome = Tako Tsubo syndrome = Apical ballooning. This disease primarily affects middleaged women, exposed to great emotional stress. The cause of the syndrome is not yet established. Sometimes we see patients with blood clots formed elsewhere in the body, and which have been flushed to the coronary arteries, clogging them. Sometimes they disappear during resuscitation, and are not seen during coronary artery catheterisation. Both these types of cases could have cardiac arrest due to rapid arrythmia.

Very rarely, patients develop an viral or autoimmune irritation of the heart muscle (myocarditis), which can reduce the EF, and give rise to either heart rhythm block or rapid heart rhythm. But it is uncommon to develop in a few hours, rather over days or weeks.
 
Jun 20, 2010
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Obviously, all the above is speculative, however, as a cardiologist, I find it important for cyclist to know a little about the condition. The awareness could cause more cyclists to learn CPR, and make cyclists that faint during exercise or have bouts of rapid heart rate, or have had family members die early and suddenly (unexpected) seek relevant medical attention.
 
Mar 13, 2009
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ulrikmm said:
Obviously, all the above is speculative, however, as a cardiologist, I find it important for cyclist to know a little about the condition. The awareness could cause more cyclists to learn CPR, and make cyclists that faint during exercise or have bouts of rapid heart rate, or have had family members die early and suddenly (unexpected) seek relevant medical attention.

Very true! This also counts for us hobby cyclists in my opinion, since we don't know our body and our limits as well as professionals do.
 
Jun 22, 2010
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ulrikmm said:
2 comments:

Of course he did not ride TdS with an left ventricular EF of 15% = 25% of the normal heart function. Such patients would have heavy breathing, trying to walk uphill. The low EF can be the result of a prolonged cardiac arrest - which he probably had, given that hypothermia was necessary afterwards.

Actually, ARVC is not only a right ventricle condition. An understanding is beginning to emerge, that this condition frequently involves both ventricles (= pumping chambers), and sometimes primarily the left ventricle. We know this, because families exist, where patients with all three types of conditions exist, and all have the same ARVC gene defect.

Very rarely, we see patients with normal coronary arteries and acutely reduced left ventricular AF. Eg. the broken heart syndrome = Tako Tsubo syndrome = Apical ballooning. This disease primarily affects middleaged women, exposed to great emotional stress. The cause of the syndrome is not yet established. Sometimes we see patients with blood clots formed elsewhere in the body, and which have been flushed to the coronary arteries, clogging them. Sometimes they disappear during resuscitation, and are not seen during coronary artery catheterisation. Both these types of cases could have cardiac arrest due to rapid arrythmia.

Very rarely, patients develop an viral or autoimmune irritation of the heart muscle (myocarditis), which can reduce the EF, and give rise to either heart rhythm block or rapid heart rhythm. But it is uncommon to develop in a few hours, rather over days or weeks.
The Tako Tsubo syndrome brings up some concerns I have as to the effects of racing on the heart; the slow heart rate that Lance brags about, is it negated by the stress hormones from racing? Has anyone done longterm studies of racers and longevity? And is the length of the races another factor that can be detrimental to the heart, given a recent study showing higher than expected rates of atrial fibrillation in marathon runners? This all concerns me and I limit my riding to no more than 60 miles/d, and let the sprinters go ahead of me.
 
May 31, 2010
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someone else has probably written this earlier in the thread, but i don't really want to read reams of stuff so - i don't think it is the right or proper thing to speculate that kim may have been doping while he lies in a hospital bed fighting for his life.
 
Mar 13, 2009
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Kim Kirchen's wife Caroline gave birth to twin boys today, Liam and Mika.

Good news for Kirchen, this will certainly raise his spirits.

Also, Luxembourgish cyclists are into extraordinary names for their children. We got Leeah Schleck, Liam and Mika Kirchen. :D