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Heart Disease (Expert Forum)
Arrhythmia and Bundle Branch Diagnonis
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.
Arrhythmia and Bundle Branch Diagnonis
by Hmann, Jul 26, 2006 12:00AM
I’m male, mid 50’s, excellent health, very low heart disease risk level. Several weeks ago with any exertion (running, yard work), I began to experience fatigue, out of breath, slow pounding heartbeat (60-70 bpm) with uncomfortable hardening of stomach wall. EKG and stress echo confirmed a dysrythmia and left bundle branch block. But stress test couldn’t get pulse to go above 78 bpm. Had fatigue, gasping for air, pounding in chest, and stomach wall hardening. (Technician stopped the test due to the dyspnea). Yet, with no exertion, I have no symptoms.
Cardiologist says stress test was “invalid” due to the low BPM, and recommended that I “force” my heart rate over 140 using Persantine. He dismissed the out-of-breath experience as “possibly some sort of lung problem” (non smoker, no prior lung issues, no exam done), and ignored the stomach wall hardening.
Do you think it’s OK to “force” my heart rate to 140 given the fact that we can’t seem to make that happen naturally? Are the out-of-breath and stomach hardening issues both symptoms that should be so easily dismissed? Should I be looking for a second opinion on diagnosis and finding out what’s wrong?
Cardiologist says stress test was “invalid” due to the low BPM, and recommended that I “force” my heart rate over 140 using Persantine. He dismissed the out-of-breath experience as “possibly some sort of lung problem” (non smoker, no prior lung issues, no exam done), and ignored the stomach wall hardening.
Do you think it’s OK to “force” my heart rate to 140 given the fact that we can’t seem to make that happen naturally? Are the out-of-breath and stomach hardening issues both symptoms that should be so easily dismissed? Should I be looking for a second opinion on diagnosis and finding out what’s wrong?
Doctor's Answer
by CCF-M.D.-MJM, Jul 26, 2006 12:00AM
Hello Hmann,
I am not sure what to think of the stomach wall hardening either -- that certainly doesn't sound cardiac. Your other symptoms do sound related to heart rate. If you couldn't get your heart rate above 140 with exercise, I don't think persantine will get it their either -- but persantine doesn't need heart rate to achieve adequate stress test results. I agree that perusing a stress test is important to rule out other causes for your symptoms.
It sounds like you may have conduction system disease in your heart -- this is the electrical side of cardiology -- versus coronary artery disease which we call plumbing. Once you rule out coronary disease, it is probably worth seeing an electrophysiologist about a pacemaker. Chronotropic incompetence is a big word that means your heart rate does not appropriately increase for a given physiologic demand. We treat this quite effectively with a pacemaker.
I agree that looking into coronary problems is first, but once that is done, look to the electrical side because that is my bet on where your problems might be.
I hope this helps and thanks for posting.
I am not sure what to think of the stomach wall hardening either -- that certainly doesn't sound cardiac. Your other symptoms do sound related to heart rate. If you couldn't get your heart rate above 140 with exercise, I don't think persantine will get it their either -- but persantine doesn't need heart rate to achieve adequate stress test results. I agree that perusing a stress test is important to rule out other causes for your symptoms.
It sounds like you may have conduction system disease in your heart -- this is the electrical side of cardiology -- versus coronary artery disease which we call plumbing. Once you rule out coronary disease, it is probably worth seeing an electrophysiologist about a pacemaker. Chronotropic incompetence is a big word that means your heart rate does not appropriately increase for a given physiologic demand. We treat this quite effectively with a pacemaker.
I agree that looking into coronary problems is first, but once that is done, look to the electrical side because that is my bet on where your problems might be.
I hope this helps and thanks for posting.
Member Comments (2)
by axg9504, Jul 27, 2006 12:00AM
Don't feel alone there are probably many like you out there. I for one have been pursuing this for 4 years. I get dizzy after running for a few minutes. It always happens after I stop and catch my breath and start a few minutes later. My real problem however is that sometimes AFTER exercise I fall into bradycardia (40's and below) that can last for several hours. I have also had the symptoms you mentioned on doing light yard work. However there are some days when I can do a lot more than others with no problems. My EP has suggested a pacemaker too. I'm stalling I don't want to put one in until I have problems without doing any exercise
