Well, I think that our medical providers have become so used to people who are in the 80% category that when they actually have to deal with someone who is fit, like my husband, they don't know what to do. Sorry for the thread drift, but it seems pertinent to our situation right now.
He has a terrible family history on both sides. Heart disease and strokes galore. He started exercising and eating better at age 42 or 43. Almost five years ago (he's 52 now) he started getting the classic jaw and neck pain when we were running. Tests showed nothing, but he did have high cholesterol and BP. He started on meds, got those down promptly. The next year, the pain returned when cycling. It got worse and worse, but still the stress test showed nothing. After we insisted, he had an angiogram, and of course, there were 2 80% blockages, so they put stents in.
All was fine until a year later, again when riding, he had pain. We went to the ER, and they sent him for another angiogram. Nothing had changed and they couldn't figure out why he was having the pain. Now, all of a sudden, after 3 years, he is having it again, but only when his HR is above 140, and at the beginning of rides. Guess what? The cardiologist says, "So, just don't ride that hard." They just don't get it.
Because he is so fit, it's easy for him to keep his HR low. If he keeps it low for awhile, then he can let it get up with no pain.
I insisted he get a second opinion at Brigham and Women's. We are going there in 2 weeks, with the hope that there might be a cardiologist that has actually met a fit person.