Excessive heart rate when exercising.

[Terri C.]

My 11yr old son has problems with exercise intolerance.  Although he is very active (plays outside, plays baseball, snowboards, scooters, etc. and looks very fit), he has always had problems keeping up with friends while running, bike riding, etc. Because of this, he has given up sports such as soccer and basketball, although he as a great desire to play. It is becoming increasinly obvious in PE and sports that he is struggling.In the past year, he as been evaluated by Pulmonary and Cardiology.  Although he has some problems with asthma, it appears that exercise induced asthma is not a big factor.  His EKG and echocardiogram also appear normal.  What did show through 2 different stress tests (one on a bike and one on a treadmill) is that his heartrate(HR) went up rapidly and quite high.  He reached target HR in 1/2 the time expected and he went to maximum HR rather quickly (the dr.'s actually stopped the bike at about 4 1/2 mins. but did state he had maximum effort with an abnormal result. Deconditioning was noted and that is where my questions begin. FYI, the Pulmonologist agreed that deconditioning "did not make sense".  He stated that he has done many stress tests on children of various fitness levels and he had not really seen the heart response like his before.  How can a very active 11 year old with a great desire to participate and excel, be so deconditioned? Am I expected to "train" my son?  If so, how?  (My son has an appt. with a Ped. Cardiologist in late Feb. whose specialty is HR.) What else might be going on to cause his HR go so high, so quickly?

[CCF-M.D.-KE]

Dear Terri,

Thanks for your quesion,

This is an interesting case. All the diagnostic tests your son has undergone appear to be within normal limits.  If your son is physically fit and has always had a problem keeping up with the other children, I am not sure if deconditioning is the answer. I am sure his doctors have ruled out any medications that could increase his heart rate. Certain asthma medications (beta agonists) can increase the heart rate. The problem your son is facing may not be primarily a cardiac issue, but secondary response to another problem. I am sorry I can not be more helpful, I would need much more detailed information to comment further.  
I think that seeing a pediatric cardiologist is an excellent idea.  I am an adult cardiologist and have limited experience in this area.  


Thanks for your question,


CCF-MD-KE

[Dakona_Fan]

I am a 17 year old female that has just had an ablation to correct SVT, a condition that causes the heart to race very fast for long periods of time. What your son has sounds very similar to what I have. At around the same age, 11, I noticed that if I had any adrelaline or/and was exerting myself I got very short of breath and my heart raced. At first I didn't understand why I couldn't keep up with everyone else. I thought that this was asthma, but the shortness of breath was only a symptom of SVT. My case was fairly severe, I was having episodes up to 4 or 5 times per day before I knew this was abnormal. I would mention to the cardiologist that it is possible that the problem could be SVT.....

[greendot]

dakona_fan

i am a 30yo male and have SVT. i get afib once a year and use atenelol to control it.  my cariologist recommened ablation, but the idea of surgery freaks me out.  i have read about about it and seems like anything can go wrong and end up on a pacemaker.  i plan to get on a clinical trial medication to control my afib, against my cariologists advise.  

my question to you: how was the procedure? how do you feel now? can you give me discription how the surgery went. thanks!

[Dakona_Fan]

The catheter ablation, for me, was nothing ot be worried about. The risks are only about 1%. My procedire was three and a half hours. They found my acessory electrical pathway, on the right side, behind my normal one. This made it a little more difficult for them, they also discovered that I have dual AV nodes.
I did wake up part way through, but I only vaguely remember it. It was while my heart was racing. When I woke up I expected to be very groggy, but I was wide awake, able to tell my parents I was hungry!! I went home that night (about 3 hours after finishing the surgery). My leg was a little sore but it felt much better within about 2 days. During the rest of that week, I was very tired. I am still not sure if the problem is completely fixed, only time will tell.
Hope this helps!!!

[fast_pace]

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