Ejection Fraction 35 or Under - Can He Ride His Bike

[Trek35]

My husband had Anterior MI w/multiple cardiac arrests two years ago (comatose x1 week, on life support, sustained MOD, treated with hemodialysis for a month); Anoxic encephalopathy still a problem, with the short-term memory deficit.Also suffered ischemic colitis & GI hemorrhage, secondary to the MI.  Anemic (last hgb 13). Has pulmonary hypertension with RVSP of 90, some tricuspid and mitral regurg. ICD/Pacemaker inserted in 2008 for fainting episodes with relief. Chronic but no acute CHF since late 2007. BNP was 60 (checked 10 days ago). Some of meds: Plavix, EC ASA 81 mg, Metoprolol XL, Benicar, Flomax, Lipitor, Lexapro, Vitamin, Folbee, Ferrous Sulfate.
NOW THE QUESTION.  He is adamant that he wants to ride his bicycle.  One doctor said that he can try it.  The other one said that he shouldn't, because of cognitive and neuro deficits. I prefer that he NOT ride, as I am fearful that he will fall, and hurt himself, thus negating all the progress he has made so far. He did used to ride long distances of 50-100 miles, when he went out.  Is there a way to have him evaluated from a cardiac and neuro standpoint, to find out if his balance IS okay and if his cardiac function is up to even a short ride, i.e., one block?  He burst into tears a week ago because he wants so badly to ride his outdoor bike, not the stationery bike, and as a caregiver and nurse, this is really difficult. I appreciate your opinion.

[Encephalomalcia]

I went through this with my mom.  She wanted to get on her bike and ride it.  She had severe coronary artery disease.  Her left ventricle started shutting down two weeks after she wanted to ride the bike.  She had heart surgery, but it was not successful and she passed away after much suffering.  I think that what was happening to her is that the adrenaline was kicking in.  You may want to check to make sure that the Metoprolol XL is at the strength that he needs, especially if the bike riding is a new request.  I am not sure how he would even to able to ride a bike with his heart condition. I, myself, have not been able to ride a bike since I was 23 because of a rapid heart beat triggered by exercise.  I passed out when I tried to ride a bike. I am sure that what he is experiencing is frustration from not being able to do the things that he loved to do before.  It is probably more than just the biking.  Take care.    

[Trek35]

I appreciate your taking time to respond.
And I am really sorry to hear about your Mother.  

You are right. He is very frustrated about not being able to do the things that he enjoyed doing before, and especially the biking.  He mentions it several times per day.  I know that emotionally he needs it, but am fearful that physically it could "do him in".  

Am taking him in to talk with a CHF specialist and neurologist.  Maybe if he hears it from a couple doctors, he'll finally realize that it's not a good idea.

Thank you again.

[Trek35]

Took my husband to the CHF Specialist today.  You were right.  He cannot ride his bike.  He can use the stationery bike (with mattresses surrounding the bike).  
Thanks again.

[Encephalomalcia]

Glad to hear that he will not be riding his bike.  I have no current heart problems other than tachycardia when exercising, but when I am at the gym the instructors usually tell me to get off of the bike. It is embarrassing, as I would like to bike and burn some calories, but my heart rate gets up there extremely fast and I cannot speak. Make sure that he is able to talk while on the stationary bike.  When a person cannot talk that means that their heart rate is extremely fast.  Hope he is feeling better.  It is tough to adjust to limitations. I just read an article in consumer reports the other day, which stated that a study has shown that people with CHF can improve their heart with exercise.  It was thought before that exercise would not help CHF patients.  This study proved that wrong, which is good to know that there is something that can be done to improve ones heart.  Take care.  

[pfr]

I had a new aortic valve, fixed mitral valve, a mace procedure, a bypass and a defib installed 5 mos ago. My EF was 27. I have just finished cardiac pt; I had been biking about 20 minutes there, and generally can do ok  on a mountain bike as long as the hills are not too long or big.
Dr's say do it, just don't overdo it. My heart rate has generally stayed down, I guess from the beta blocker and limitations of my pacemaker/ defib.
I need to see the consumer's report article.