Whistler triathlete Karsten Madsen acknowledged he wasn't initially satisfied with his third-place finish at the Xterra Victoria race on July 7.
After all, he'd won the event in 2016 and 2017.
But there was something a bit different this time around, as less than a month before the race, Madsen had a heart procedure to diagnose arrhythmias in his heart.
"Initially, when I had finished, I was really frustrated that I didn't win. I want to win everything that I do. That's my competitive nature," he said. "Quickly, I pulled myself out of that funk and was giving myself a bit of a break on that. The last two months has been an absolute sideshow."
In terms of the offroad triathlon race itself, the 27-year-old placed four minutes and 27 seconds (4:27) back of winner Sam Osborne of New Zealand and 2:18 back of runner-up Josiah Middaugh of the United States.
"I didn't go into the race with the best fitness, and I knew that going in," he said. "I knew what I could do, what I couldn't do.
"I had, actually, a worse swim than I predicted, so I had my work cut out [for me] on the bike."
Originally from Guelph, Ont., Madsen has subsequently adapted to B.C.-style trails in the time that he's been in Whistler, which gave him a boost heading into that portion of the race.
"A lot of those guys, they reside more in Colorado, or the guy who won is from New Zealand, and I don't think they're as good at downhill singletrack as maybe what I am, so I knew that if I rode really clean and fast on the descent," he said. "I knew I could keep myself in the race."
Toward the end of the biking section, Madsen played some cat and mouse with Branden Rakita, who was then in third, but eventually finished 16 seconds back of Madsen in fourth.
"I felt on paper that I was a better runner and I didn't want to close the gap of 20 seconds [on the bike course.] I didn't feel it was worth it," Madsen said. "Instead, I'd rather he have a sense of security that he's in third and that he's holding third.
"Coming into the run, I basically stomped the first two kilometres, got a gap on him."
At that point, however, Madsen became concerned about how he would hold up the rest of the way.
"Sure enough, I could feel the wheels kind of starting to come off, but it was after I'd done the full climb," he said.
During the descents, Madsen was mindful of how he ran, knowing that a fall would cost him dearly. However, he held a 20-second advantage over Rakita on flat ground to finish off the race.
Madsen crossed the line less than a month after his procedure to suss out which heart arrhythmias he has. Madsen collapsed during the Xterra World Championships in Spain in April and had tests performed on June 12, days after winning the Whistler X Triathlon.
"There were four catheters in my femoral artery that went up into the heart. They induced arrhythmia, essentially trying to figure out why certain arrhythmias happen to me," he said, adding that tests revealed atrial fibrulation and supraventricular tachycardia.
Madsen's training for the bulk of the Xterra season, with the start marked by the Victoria race, was interrupted by the tests. He originally had a 10-day rest period before he could get back at it. However, he also picked up a virus in the hospital, which extended his recovery time to two weeks.
"You can't just go back to training because deep inside in the artery, they've made punctures," Madsen explained. "You need that area to clot and to heal back up before you're really able to exert yourself.
"Your femoral artery is something you don't want bleeding."
After the tests, Madsen spoke with his doctors and his family balancing the risks of leaving his arrhythmias untreated for now versus fixing it with ablation or cryogenic freezing.
He said the treatments have a 95-per-cent success rate, but if something went wrong he would require a pacemaker and his athletic career would be done. However, the arrhythmias are not yet impacting his quality of life and not yet enough of a concern to require fixing, Madsen said.
"We all agreed that this has not happened regularly enough yet for us to take that kind of risk," he said. "Let's see if we can go another 10 years because obviously, that would be the best-case scenario. Go another 10 years without having a major issue and in 10 years' time, I could be done racing and it might not be a problem again."
While there aren't any physical changes to Madsen's heart right now, he said he has a change in mindset as he continues his athletic career. It's simple: if something feels wrong, stop.
"There's no more toughing out stuff. If you feel an arrhythmia come on, or the onset of it, it's immediate, you need to pull out," he said. "In Spain, at the World Champs, I kept pushing through it, going in and out of the arrhythmias and essentially what happens is there's a loss of blood pressure. Your heart is doing all sorts of wacky things and your body doesn't really know what's happening.
"Basically, it takes all the blood away from your brain."
While Madsen was disappointed not to win gold in his first race back, he acknowledged those who bested him are strong competitors, most notably Osborne, who won third at the World Championships. However, a stronger Madsen will take them on again this weekend in Quebec City.
"These are guys where you will not beat them if you're not at your 100-per-cent level," he said. "Everyone is at a superior level.
"I'll race again next weekend, and the idea is to be a little bit better than Victoria."