On June 24th, 49-year-old Dave Goldfain was attempting to complete the Four Seasons of Horsetooth Challenge course for the 12th time before a heart attack derailed his ride. The 20-mile course takes riders on a tour of some of the best trails in Lory State Park and Horsetooth Mountain Open Space and is the course for the Four Seasons of Horstooth Challenge, a year-long grassroots race that takes place over the course of a long weekend during the winter, spring summer and fall. Thankfully the marketing expert and founder/CMO at Cereal survived the emergency thanks in part to being in remarkably good physical condition. He’s ridden Towers Road an astonishing 54 times in 2023, 103 times in 2022, for a total of 443 times. He’s officially Strava’s local legend on that segment. Given that, I do question his mental health. He also rides with Seth Picket, Mike Weber, and others very early in the morning during their Dawn Patrol rides on a regular basis, which only adds to my concerns. According to doctors, there were no preexisting conditions, signs or much he could have done to prevent/predict the emergency.
On June 24th, Goldfain was at the top of Southridge Trail the high point of the course, about 10 miles in, when he noticed an abnormal lack of energy. Sign #1 as Goldfain puts it. I’ll let him take it from here. Follow-up questions and tips for surviving a trailside cardiac emergency are below.
Dave’s Firsthand Account
…On the Wathan descent, I thought I had indigestion. No big deal because it’s Wathan. That was sign #2. Halfway down Wathan, both my arms went numb and I thought it was time to throw up. When it was strong enough I couldn’t resist, I pulled over to rest. I was in fetal position, sweating, throwing up, and couldn’t catch my breath. Those were all definite signs. No pain, I still just thought indigestion (I’m stubborn). But all those are classic heart problem symptoms. I’ll spare the details but several things saved me on Saturday… First of all, I had cell reception, and stopped my Strava and uploaded it. That’s how my wife and bro could tell 911 where I was. Later, I Strava’d the helicopter ride and shared my beacon so my wife could see where I was going. I couldn’t talk, but I could do that. Next, the EMTs who showed up first on the scene hooked me up to an EKG. That told them I had a heart problem. That’s when they landed the chopper so it could take me to MCR. The medic immediately gave me 4 chewable Aspirin and and IV with Heparin. I would find out later that action saved my life (they thin blood and make platelets slippery). The teams who helped were amazing, from Matt V who stopped to help me, to my wife who called 911, to the rangers, to the EMTs and Poudre Fire, to the air medics. I am so thankful. The heart surgeon would later tell me that everyone has plaque in their arteries. In my case, I only had 10%. But some dumb little piece decided to break off during my ride (probably the top of Southridge, with multiple doctors denying that overexertion caused it). That plaque breaking off caused a small bleed on the inner lining of my LAD. Platelets ran to that scene and formed a clot. That clot created a blockage of 95% in a matter of minutes (middle of Wathan), where my full symptoms manifested. I was told that a calcium score is highly recommended to get a baseline of plaque build-up, but in my case I would’ve been given a clean bill of health. What saved me was cell service (so my wife called 911 despite my denial and just saying it’s indigestion), I could share a beacon about my location via Strava (so I could be pinpointed), the EMT administered Aspirin (always carry 4 chewables now and take if suspicious symptoms arise), and Heparin (sorry, only given through IVs). Plus the amazing individuals who’s job it is to look after those of us who need help. If you even suspect something may be wrong, that decision to call 911 could mean the difference between life and death. Thank you all for the prayers, the support, the love. I hope you don’t have to go through this, so take the precautions that you can. ***AT A MINIMUM: Be findable (beacon your ride if you’re alone), pay attention to your body (don’t blow off indigestion, fatigue, or excessive breathing and sweating), and pocket some Aspirin (4 chewables). See you on the trails again soon.
Followup Questions
How long until someone else (another rider?) showed up? After getting off my bike to lay down on the side of Wathan (sweating, trying to catch my breath, throwing up), it was 5-10 minutes when Matt Vesgaard, another mountain biker, showed up.
What did they do? They stopped immediately, saying “Hey man, are you ok? Do you need any help?” I had my phone next to me on speaker and my wife asked him to stay with me until paramedics came (I couldn’t talk well at that point). He stayed with me until well-after the Rangers and EMS teams came to ensure all was well. He was there over an hour.
Who did you call/when/where? I first called my wife. Thankfully, I had one reception bar on my phone. Another 100 yards down Wathan and I wouldn’t have had that. I couldn’t talk well because my breathing was so excessive, so Matt answered questions. I also stopped my Strava app from recording and uploaded it. That let my brother see where I was and he took a screen shot, sent it to my wife, and she sent it to 911 dispatch. I was two-thirds of the way down Wathan and made that call to her at 6:46 a.m., a little over an hour into my ride.
How long until first responders showed up? The first person after Matt to show up was a Ranger. Apparently, they sent a team up Towers and one up Southridge. It was the Southridge route that got to me first. My time-keeping may not be the most accurate, but I think it was around 25 – 30 minutes from my call until they showed up. Honestly, I didn’t want my wife to call 911, but wives do that kind of thing. Now, I am grateful.
How did the first responders actually obtain/use the Strava info? Did you call your wife/brother and they sent the strava file to 1st responders? I think that info is above. A screenshot of my location was sent to my wife which was sent to 911 dispatch. Also, 911 dispatch texted me a link to click on that would help with my location. It was hard for me to use my phone at this point, so I’m not sure which one went through that actually helped the most.
How long until the helicopter showed up? The helicopter started swirling around the area before any of the Rangers or EMS teams showed up. I was suspicious, and asked the EMS crew, “what’s with the helicopter.” They said, “we put that in the air when there’s a potential back-country call like this.” Little did I know I would actually need it. The EMS team took a sample of my blood to measure blood-sugar, then shaved a small part of my chest and hooked up a portable EKG. It’s impressive the amount of equipment and people that showed up – from both the Ranger side and the EMS side. After a moment watching the EKG print off a small strip of paper, the gal running it looked me in the eye and said, “it’s your heart, and you’re getting on that helicopter.” Then she gave me 4 chewable Aspirin, they put in an I.V. in my left arm, and administered Heparin. The cardiac surgeon the next morning told my that action changed my story.
How long were you in the hospital? I was at MCR 2.5 days
What did they do? I was taken into the cardiac trauma unit, and was quickly briefed on what was going to happen. They were going to go in through my radial artery, a relatively new process that used to be through the femoral artery. They could see that I had just 10% plaque in my LAD (not bad), but a small bit of plaque broke off and caused a clot to form (not good) which caused 95% blockage. That clotting process was stopped when the Aspirin and Heparin were administered on the trail, ultimately saving my life and buying time until a surgeon could get in there and deal with it. The stent the surgeon put in covered this area, completely opened it back up, and is coated with medicine that prevents scar tissue. That surgery took about 1.5 hours.
How long until you can be back on the bike? 1 week I can’t use my arm (it’s all swollen and purple), and 2 weeks with no exertion. After that, there will be some cardiac rehab to rebuild and monitor my heart which will open conversations with doctors about when I can get back on the bike.
Any family heart attack history? Dad had some serious heart issues 15 years ago, but this was said to not be genetic, nor would it have been detected as a risk in a calcium score.
Are there any tests that could have predicted your heart issue? The cardiac surgeon highly recommended a calcium score be done. It’s my understanding that test indicates how much plaque build up may be in your heart… But I was told in my case it wouldn’t have helped because I only have 10% plaque.
Was there anything that could have been done to prevent it? We were specifically told that there was nothing I could’ve done to prevent this. That was heard from the heart trauma surgeon, a cardiac doctor and a follow up cardiac rehab nurse.
To clarify, it wasn’t the plaque that damaged anything, it was the bleeding it cause when breaking away from my artery. That bleed on the inner lining of my LAD caused a clot to form in a matter of minutes, which caused 95% blockage.
I just want to reiterate for the outdoor athletes out there:
- If you’re alone, let people know where you are, sharing a beacon or using a Garmin if you’re able. First responders confirmed receiving the screenshot of my Strava location, which helped pinpoint where I was.
- Pay attention to your body. I thought I had indigestion, which it could have been… but coupled with excessive sweating, inability to breathe well, dizziness, and indigestion, they are all classic heart symptoms.
- Don’t be afraid to call 911 if you think you have potential symptoms of a more serious issue… let the trained experts help decide, it’s what they’re there for
- Carry 4 chewable Aspirin and if any suspicious symptoms arise, take them… it could save your life.
I’m happy to report that Dave is back to his predawn rides and ascents of Towers Road. His first ride back was an eight-mile mtb ride up at Horsetooth on July 12th.
