Heart of the Matter

Heart of the Matter
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The bottom line: Running is good for our hearts. But that doesn't mean runners are immune to the leading cause of death in America. Do you know all you need to know?

I'd like to introduce you to Jon Tota. Jon is married to Amy Vorland Tota, an advertising manager at RW. They have three young boys and live in New York City. He's 42, the president of a small software company, a fully engaged father—and a runner for the past 10 years, thanks to Amy, who got him started. He has run the New York City Marathon (a 3:57 in 2013), two halfs, and a bunch of shorter races. When life is hectic, he runs home from his office to get his miles in. One other thing: He's remarkably lucky to be alive.

Jon has some advice for you. You've heard it before and probably ignored it. After all, you're fit. You're a runner! No reason to worry. So I'll let Jon explain in more detail:

"We were running a 10-miler in Central Park on a Sunday when it happened. I was with my sister, Noelle. We both were training for the upcoming NYC Half. Oddly enough, that run on March 1 was the only training run I did with a partner. I usually run alone. Every step of the run is blacked out for me, so most of this is secondhand. Noelle says I seemed fine. We were averaging 8:30 miles, pretty normal. In the final 800 yards or so, I kicked up Cat Hill to finish strong. Amazingly, running behind me was a former EMT named Jim Palmer. He and his friends saw me go down. They say that from behind it looked like I hit a patch of black ice and fell flat on my face. When they picked me up, I was breathing with a lot of difficulty. I took a few steps, then collapsed and had no pulse. On my Garmin, my heart rate hit 195 then dropped straight to zero. It's eerie to see it now in my activity history.

"When I went into cardiac arrest, Jim began CPR. A nurse and doctor, both of them also runners, showed up. The three did chest compressions for 15 minutes or so until an ambulance arrived. My pulse and color returned, but at the hospital, I coded a second time. They revived me again, although I remained unconscious.

"That night, to understand why all this happened, they induced me into a coma, and used something called an arctic blanket to keep my organs cooled and minimize any potential brain damage. They did a ton of tests and discovered that I have an anomalous right coronary artery, which affects only a small percentage of the population. Basically, that artery takes a potentially dangerous course out of the heart, running between two large vessels. When the heart is pumping hard, the two vessels can strangle the artery and restrict bloodflow. It's a congenital condition that had gone unnoticed my whole life. I grew up playing sports but hadn't had any heart issues. No symptoms, no family history. Other than the congenital defect, my heart is very healthy.

"On Tuesday they took me off sedation. By Friday, I was up and walking around. No brain damage at all. I was in the hospital for 12 days, seven in intensive care. I haven't had a better feeling in my life than coming home to see my three boys.

"My doctors said my overall fitness played a big role in my fast recovery and ability to withstand the trauma. A friend joked that while running almost killed me, it's also probably what saved my life. The 2016 NYC Half is my goal now. My surgeon says we will work slowly toward running again. I may not post six-minute miles anytime soon, but I can get back to light running this summer and pick up intensity in the fall. He says beyond that is a negotiation, which I think is a nice way to say, 'We'll see.' But I intend to get back to a marathon one day.

"I was very disappointed to learn that I needed open-heart surgery. But the anomalous artery caused my heart attack, and there's no telling when it could happen again. It had to be corrected. And I now have a defibrillator in my chest to shock my heart back into rhythm if it stops again. It's uncomfortable, it bothers me a lot. But oddly, I feel more content and at peace than before my incident. And best of all, I am alive and have full use of my arms and legs. I know what I want to be at the end of all this, and it will happen. I think being a runner has conditioned me well for this life challenge.

"Here's the thing: Before this, I hadn't been to a doctor since I was in my 20s. I thought I was invincible. I've asked a lot of male friends and found it's not uncommon. I think everyone should get checked out regularly, even if you feel totally healthy like I did."

I'm 47 and do have a family history of heart disease. I know that running substantially reduces the long-term risks of developing it, but that runners are not immune. I've heard plenty of tragic stories. I was at the Olympic Marathon Trials in 2007 when Ryan Shay died, the highest profile heart-related fatality in our sport since Jim Fixx, who helped launch the first running boom, dropped dead on a run in 1984. But it wasn't until I heard Jon's story-a runner saved by runners, perhaps by running itself-that I finally stopped delaying and had my first heart screening. It revealed slightly elevated levels of HDL ("good") cholesterol but a low probability of coronary heart disease or congestive heart failure, and no evidence of the kind of abnormality that brought Jon down in Central Park, just across the road from where Ryan Shay took his last steps. I have more to do (nutritional tweaks, a stress test) but I now have some important, and immensely comforting, information. After all, according to the Centers for Disease Control and Prevention, heart disease is the leading cause of death-for both men and women-in the United States, claiming the lives of about 610,000 people every year.

Yes, I'm fit, and running makes me healthier in countless ways. But it is not a panacea. So I took Jon's advice. I hope you do, too.

David Willey is the editor-in-chief of Runner's World.

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