endurance athlete and pericarditis

[Triforlife]

I am a 51 yr old female in excellent shape.  I just had two days of chest pain (became severe on 2nd day) and neck pain, was evaluated and found to have a normal BP and pulse, +friction rub on exam. EKG changes with inferior and anteroseptal ST elevations with j points, normal T waves, otherwise normal.  Last EKG was 14 years ago and wnl, but was before I started doing serious level of exercise in the past 4 years. Echo was normal.  After 24 hrs of Medrol dosepak and Indocin 50TID I was symptom free and feel fine.  I stopped the steroids after 1 day of taking them after reading about increased risk of recurrence in people taking steroids for pericarditis and am now just on Indocin.  My question is about when to return to exercise.  The severe chest pain was three days ago and now I feel fine. I am a competitive triathlete in the top 5% of my age group and am signed up for Ironman Florida in November.  I tend to run 30 miles per week, bike 120 miles per week, and swim 3-5 miles per week priod to this episode.  Is it harmful to restart exercise next week and gradually build back to this level if I feel OK?  

[kenkeith]

Unfortunately, how well one feels can be deceiving.  There are many cases where an individual has had heart attack (MI) and did not have any symptoms until there is heart failure.  That happened to me.

ST segment elevation is usually attributed to impending infarction, but can also be due to pericarditis or vasospastic (variant) angina (chest pain). In some healthy young adults, a form of ST elevation can be normal.

There are a number of non-cardiac conditions, medication, electrolyte imbalance, etc. that are benign that cause ST elevation as well.  I agree with mammo you should consult with a doctor before any exercise regimen.

[mammo]

This is something better discussed with your heart specialist.  I know how anxious you are to return to your normal, active lifestyle, but only an expert qualifies to answer your questions.