Jan 7, 2023
Welcome to Episode #369 of the 303 Endurance Podcast. We're your hosts Coach Rich Soares and 303 Chief Editor, Bill Plock. Thanks for joining us for another week of endurance interviews and discussion.
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In Today's Show
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Endurance News:
Sudden Cardiac Arrest on National TV: An Explainer and What it Means for Triathletes
Tragic events at a recent NFL football game has athletes of all kinds asking: Are we at risk?
JANUARY 4, 2023
Last night much of the American television viewing public was taking in Monday Night Football to see a big game with playoff implications. The Buffalo Bills were visiting the Cincinnati Bengals when, after a fairly routine play, 24-year-old safety Damar Hamlin unexpectedly collapsed to the ground. The game announcers initially thought that Hamlin had simply been injured on the play, but very quickly it became apparent that something far more serious was going on.
Hamlin, it turns out, was in cardiac arrest. Once the training staff realized what was happening began to administer cardiopulmonary resuscitation (CPR). He was resuscitated again upon arriving at the University of Cincinnati Medical Center’s intensive care unit, where he remains in critical condition.
At this point, I think that is helpful to dispel confusion about some common terms that are frequently thrown around the media in these situations. Doing so now will allow for a much clearer description of what happened to this player, and help unpack whether this incident should be a cause for concern for endurance athletes who are all too familiar with the specter of sudden cardiac death (SCD) in our own sports.
RELATED: Do Triathletes Need to Worry About Heart Attacks?
Heart Attack vs. Cardiac Arrest
The first thing that needs to be made clear is the difference between a heart attack and cardiac arrest. A heart attack occurs when there is a blockage in one of the arteries that carries blood to the tissue of the heart. The heart muscle is exquisitely sensitive to dips in oxygen-rich blood flow, so if a coronary artery becomes obstructed, the cells that are being fed by that artery do not receive oxygen—they become injured and quickly die. In medical terminology this is called a myocardial infarction. In the spring of 2021, professional triathlete Tim O’Donnell experienced a heart attack while competing in a race. Fortunately, he did not suffer cardiac arrest.
Cardiac arrest, on the other hand, occurs when the heart ceases pumping blood forward to the brain and the rest of the body. There are many causes for cardiac arrest and one of the more common ones is a heart attack. However, while cardiac arrest is frequently caused by heart attacks, only a small percentage of heart attacks cause cardiac arrest. During cardiac arrest, the heart can come to a standstill in which case all electrical activity ceases. This is known as asystole, and is typically represented in popular culture or on TV as a “flat line” on a cardiac monitor. More commonly, the initial electrical rhythm in cardiac arrest is either ventricular tachycardia—in which the ventricles of the heart are being stimulated to beat so fast that they do not have an adequate amount of time to fill with blood and therefor the pumping action does not result in any blood flow—or, ventricular fibrillation, in which the electrical activity in the heart is chaotic and disorganized and the muscle just quivers and no pumping occurs at all.
Whatever the underlying rhythm, during cardiac arrest there is no blood flow to the brain and it is imperative that two things happen as quickly as possible: CPR must be initiated and if indicated, cardiac defibrillation must be done. CPR is the application of chest compressions to the victim and is how some forward blood flow can be re-established until such time as the heart’s normal electrical activity can be restarted. Cardiac defibrillation is the application of an electrical shock to the heart. In the setting of either ventricular tachycardia or ventricular fibrillation, this shock works to depolarize the entire heart muscle and resets the electrical system. That brief moment of pause is then hopefully when the heart’s normal pace making activity can kick in and a normal rhythm can resume. Defibrillation does not work for asystole, so all those times you see characters on television or movies attempting to shock a patient who has a flat line shown on a cardiac monitor, that is just not going to work!
Are endurance athletes at risk?
As I mentioned earlier, SCD is a very real issue for endurance athletes, and Damar Hamlin’s incident rightly heightens awareness once again on the potential tragic consequences of training for and racing in our sport or any other where we put our hearts under stress. I have spoken on my podcast on more than one occasion about this subject as well, but the situation that Hamlin experienced last night needs to be clearly distinguished from those which triathletes and other endurance athletes face.
CC is a very specific and rare event that is specifically related to a blunt force trauma to the chest directly overlying the heart. Triathletes, on the other hand (as well as other endurance athletes who develop dysrhythmias or SCD) typically experience heart conditions related to structural problems from years of high-volume and high-intensity training or because of the development over time of atherosclerotic coronary artery disease that in many cases is silent.
There is unfortunately little in the way that can be done to screen athletes for these problems because as horrifying as SCD is, it remains a fortunately rare event and no screening has been shown to effectively and reliably identify those who are at risk. Instead, it remains the athletes’ responsibility especially as they age to be diligent about paying attention to their body and being attentive to any signs or symptoms that could be attributable to an underlying cause.
Palpitations, shortness of breath at lower than expected amounts of exertion or any kind of chest pain with exertion should be signals to an athlete to cease training and seek immediate medical evaluation before returning to training. While commotio cordis is simply not likely to be an issue for triathletes, SCD remains a very real—if thankfully rare—event. While the cause may be different, an outcome similar to what Damar Hamlin experienced is still a possibility, one that we would all like to avoid at all costs.
IRONMAN Announces Nice, France as the 2nd IMWC Location
TAMPA, Fla./NICE, Fra. (Jan. 5, 2022) – Following the previous announcement of the IRONMAN® World Championship continuing its commitment to dedicated race days for men and women, it was announced today that Nice, France will become the location for the 2023 men’s edition as co-host of the VinFast IRONMAN World Championship.
The race will take place on September 10, 2023, adding to the history of the European birthplace for long-distance triathlon. As previously confirmed, the women will race on October 14, 2023 in Kailua-Kona, Hawai`i. In 2024, the men will rotate to Kona racing, on October 26, 2024, while the women will rotate to Nice and race on September 22, 2024. The rotation will continue through 2026 with Nice and Kona acting as co-hosts for the pinnacle event in triathlon.
Acknowledging the importance of continuing a dedicated IRONMAN World Championship event for both women and men, IRONMAN quickly identified Nice, France amongst other world-renowned candidates as a familiar and historically important triathlon destination to join as a dual host for the event. The city has all the attributes to provide the backdrop for an exceptional world championship experience.
“In 2022, we saw the power of a two-day IRONMAN World Championship, one with dedicated race days for professional women and professional men. We believe in this concept not only to showcase the depth of both the women’s and men’s fields but also to invest further into the growth of the sport of triathlon. Nice, France, as the European birthplace of long-course triathlon is the right place to showcase this evolution,” said Andrew Messick, President & Chief Executive Officer for The IRONMAN Group. “We are grateful to Mayor Estrosi and the City of Nice, who share our vision of creating a world-class championship race for the men in 2023, and then the women in 2024.”
A 2023 Buyer’s Guide to America’s Best Bicycle Insurance
With the right bike insurance, a cyclist can protect their bicycle or eBike, while riding or in transit, bike accessories, and theft of the bicycle with optional theft protection.
January 4, 2023 / ENDURANCE SPORTSWIRE – BikeInsure, an insurtech company specializing in bicycle accident coverage for cyclists in the United States, has released a 2023 Buyer’s Guide to America’s Best Bike Insurance. Today’s cyclists need a standalone insurance policy to protect their new or used bicycles and eBikes. BikeInsure provides damage reimbursement for repairs to your bike and listed accessories due to riding accidents. And during transit. The BikeInsure plan extends to a stolen bike or eBike when optional theft protection is selected.
Standalone Bicycle Insurance refers to a separate bike insurance policy that covers specific risks not covered by your existing policies. For example, the Forbes Magazine article “Do you Need Bike Insurance for Your Bicycle?” addressed Bicycle Damage, “You crash your bike. If you crash into an object like a tree or car, you typically won’t be covered under a home, condo, or render insurance policy for the bike damage.” The BikeInsure standalone insurance plan will not compromise a cyclist’s homeowner’s insurance if a bicycle accident claim occurs.
“Unlike the few traditional bike insurance companies in the United States, BikeInsure has Standardized Bike Insurance, a simple 2-minute sign-up comprehensive insurance for bicycles,” said Buzzy Cohn, CEO of BikeInsure. BikeInsure innovated a process that allows a cyclist to obtain bike coverage with optional theft protection for a bicycle as quickly as it was to get for your smartphone, all from the BikeInsure website. In addition, the comprehensive insurance for your bike or eBike includes a standardized $10,000 limit and a $100 deductible for only $16.99 monthly.
“While cycling is safe, accidents do happen,” said Ira Becker, President of BikeInsure. “Now available to cyclists across America is standalone bike insurance that is standardized with real value and reasonably priced coverage. BikeInsure is the solution for bicycle insurance.”
Closing:
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Stay tuned, train informed, and enjoy the endurance journey!