Oh brother. 
I'm just wondering how so many men within our industry [Strongman, powerlifting, bodybuilding] can stay so heavy so long, without reading the writing on the wall. As a hyper-stimulated autistic, I can basically feel my heart beat at 55 beats a minute.
There's no chance I could get to the point that some of these guys got to without noticing problems.
Do most notice the writing on the wall, but ignore it? Or do some just go from feeling perfectly well, to dropping dead?
I remember in 2013, when top Strongman Mike Jenkins died. He was just feeling normal one day, and didn't wake up the next. He had only just turned 31. He was 6'6" and 390-lb, but basically went from being in Strongman contest form, to being dead.