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Exercised Induced Tachycardia?

Dear Dr.

Lately it seems that my heart rate is taking longer to return to resting after exercise than usual. For the last several weeks, I exercise at 140-150 bpm for 45-50 minutes, and after 15 minutes cool down, my heart rate is still in 120-130 range. It used to come down to 110 or so after that time. I'll admit that I tend to panic if my heart rate is in any way suspect, but I think I am seeing a difference in the last few weeks. I take a diuretic for high BP, and I wonder if I may be dehydrated, but there has no change in BP medication in last several weeks. Also, 3 months ago my doctor increased my thyroid medication, so this may be a factor. Other than post-exercise, my pulse is behaving nicely. I had an echo 2 years ago that was "normal".

Please advise.
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Avatar universal
I'm new to this particular website and was looking for a particular item about heart disease when I stumbled upon this area.  I do not have heart disease and have no idea what most of the medical terms you are using are, but I do know about anxiety and panic attacks.  So hear goes.

If you go to a doctor and he cannot find anything wrong...stop looking for something to be wrong.

My panic attacks caused me to spend thousands of dollars on doctors and tests that never needed to be done.

Yes my heart raced when it wasn't supposed to.  I had every indication of a heart attack without having one.  The more I worried the worse it got.  The more I read about diseases and stuff, the worse it got.  The more I talked about it, the worse it got, till I was unable to be by myself.  I lived this way from the age of 17 till I was 44.  A long time to waste.  I lived a very stunted life.  I got married, but couldn't be home alone.  We did everything together.  I got pregnant twice and didn't enjoy my first child until she was 20 because we couldn't do mother/daughter stuff cause I was scared.

If you want to get over what's ailing you and a doctor cannot help, then it most surely is mental

One reason most people stay wrapped up in the way they are is because they like the attention.  I did.  But look how I wasted my life.

Get a good Internal Medicine doctor.  Tell him/her that you've had it all done,and think it's anxiety.  After I started getting better I was told my daughter was dying and decided to go on Paxil to help me get through it.  It didn't change my personality  and relaxed me.  I plan on going off soon and if I don't okay too.

Good luck to all of you.

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Avatar universal
I guess I have a whopper for you. I am a 26 yr old female diagnossed with ARVD. I have been a competitive athlete my whole life playing soccer even for our varsity squad. I have had an ICD for about a year now and in the past year I have had 40 unnecessary shocks.

These shocks only occur when I have a had a few "social" drinks or when I am running. My ICD is set to detect only heart rates over 214 bpm. But has detected Sinus rhythem that high a couple of times. I have switched from Atenolol 25 mg twice a day to Sotalol 80 mg twice a day and now have cut back to 40 mg a day due to incidence of asthma.

In July I played 70 minutes of a soccer game.. two days later I went for a run early moring for about 25 minutes... as I started to cool down I began getting shocks form my ICD.. and eventually had 28... seems like it was "double counting" says my cardiologist. Since then I have been afraid to move.. I get scared walking up the stairs to work each morning... IS there any hope..? I can't even think of going for a trail run or to a public gym.
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Avatar universal
I read your post and I too have recently had arrythmia problems. I am 40 y.o. and I was diagnosed with benign sinus tachycardia and have developed anxiety problems relating to concerns over my heart.  I ended up in the ER 2x (once after a gym workout) with elevated hr and lightheaded/dizziness.
Now I'm taking a low dosage of Zoloft and feel much better.  I have still though had some heart racing during exercise- when I hit a certain level of exertion (125-130 bpm) something triggers and the rate jumps up to 150-170.  It's an unsettling feeling and I must stop the exercise.  Then it takes approx 15-20 minutes for the rate to subside.
  I'm curious what short-term beta blocker were you prescribed for this problem?

Rob
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Avatar universal
I completely agree with your last statement!!
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Avatar universal
I am 45 and have had all the same symptoms as others on this e-mail stream and share many of the same concerns. I often have tachycardia type events after or during exercise or after eating. Once I had to be taken by ambulance from the gym with a heart rate at 200bpm which felt like my heart was jelly. Another time I had someone waiting outside the gym for over an hour and I was too scared to get off the chair in the locker room because every time I got up my heart raced to 160 or so. So far doctors have told me after various tests that this is not dangerous but it is sometimes hard to believe.

I have found that the only help has been: (1) anti-depressents - I am taking a small dose of effexor and this seems to reduce the sensitivity somewhat; and (2) beta - blockers - I actually take a short acting beta blocker (Lopressor) around exercise time and this seems to help although sometimes when it wears off symptoms re-appear a few hours later so I need to take another one; and (3) avoiding food before exercise - the combination of some foods and exercise seems to be the worst for me.

My best guess is that I am suffering from some combination of heart over-sensitivity and probably food allergies as well. But I think that this whole area is under-studied. The more I read this web site the more I realize that the link between heart and mind has not been adequately researched.
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Avatar universal
hey jdm:
i hear you on being afraid to exercise.
as you can see by my previous posts, i have severe anxiety and panc, and have become a "cardiac-criplle."

there was a time when i would weight lift and treadmill daily without a given thought, but once my anxiety about heart disease took over, BAM!

i am a 43 yr old male, now in therapy for anxiety; on bp meds, on klonopin for panic, and like you, will not do anything that causes my heart rate to elevate, because before you know it, i am in tachycardia.

sometimes, even THINKING about doing something strenuous causes my heart rate to go up.......i  won't even clean the snow off my car, i'm so paranoid.

so, pal, you are not alone with this horrible affliction....
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Avatar universal
Hey Jerry,

I'm only 30 and I'm scared to death of doing the simplest tasks around the house ... don't even want to lift a basket full of laundry because I'm afraid it'll be too much on me! Whew! Do you guys think we'll ever get past this????
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Avatar universal
Hey.
I too zombifiy when I take my atenolol (25mg), and I only take half. I'm prescribed one daily, but just the half makes me half-baked and scares me, which leads me into a nice big anxiety attack. Did you decide to 1/4 your pill, or did your doctor suggest it? Does it make you tired throughout the day? I'm a 30 yr old female and I have 3 kids who keep me running all day which is why I chose to take mine at night, but the anticipation I get after I take it from fear it is going to once again make me feel weird keeps me up for hours afterward, allowing me approx. 4 hrs of sleep. But if you take yours in 1/4's 4x a day, and it still has the full effect, without tiring you all day long, I'd like to try it. Let me know please.

Thanks
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Avatar universal
I noticed you comment on how sensitive you are to Atenolol. I had the same problem with beta blockers (at similar doses that you are on) Beta blockers are metabolised by chytochrome P450 and I happen to have the CP2D6 that gives a slow metabolism for this pathway. Thus, little doses of beta blockers build up in  me and, if I'm on "regular" doses, I get overdosed and end up in the ER. You may have this condition as well. It is not that rare. I found that switching to calcium channel blockers helpful as they are metabolised through a different pathway.
I have a similar reaction to exersice and breathing as you do (along with lots of other probs : >).
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Avatar universal
Hi Hank & Everyone!
I have been "lurking," and just had to chime in.  Until recently, my heart rate has always been on the lower side of normal, as has my blood pressure.  My cholesterol is fine as well.  

I'm a 46 year old female, near my "ideal" weight at 130 pounds, 5'5," in excellent physical condition.  40 months ago, I was diagnosed with severe idiopathic non-A1-AD emphysema, severe asthma, allergies and gastric reflux.  I've been put on several maintenance medications for all of these conditions.  EKGs normal, 8/2002 echocardiogram also normal, and heart appears normal in annual high resolution chest CT scans.  

In April, I purchased a pulse oximeter which measures my heart rate and oxygen saturation rate.  Now, my resting heart rate (while I'm sitting typing or driving a car or doing not much of anything) is anywhere between high 90s & 110s most of the time.  When I climb one flight of stairs, my heart rate jumps to 135 BPM (& my oxygen saturation drops) & stays there until I stop moving and stand or sit still for a while.  If I climb more than one flight of stairs, my heart rate increases even more while my oxygen saturation rate drops further.

The pulmonologists (lung docs) I've seen have naturally focused on my lungs & aren't overly concerned with how high my heart rate goes.  They say it's probably my bad lungs & the meds which are causing the tachycardia.  Initially, none of them thought I needed to see a cardiologist, but when they couldn't answer my questions about my increasing heartrate, agreed I should see one & referred me (appointment in January).

Just wondering if you have any insights about this.  I agree with my docs that my heart is beating rapidly to help circulate the O2 my body wants & isn't readily getting because of my damaged lungs.  I'm just trying to figure out what the cardiologist will add to this mixture.  I know many of us who have emphysema end up with heart problems and an enlarge heart and secondary pulmonary hypertension.  I'm trying to do what I can to head all of this off.

Thanks!
Aloha,
Starion
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Avatar universal
jdm
Did the things recommended by the doctor.  Thyroid perfectly normal.  Electrolytes perfectly normal.  Hydration level very good and has no effect on tachycardia.  

Over the years I persisted and ruled out all these things.  I even consulted with an endocrinologist and inquired if my system could be producing excessive adrenaline or continuing to inappropriately when exercise ceases.  

On that score I was told that adrenaline has a short half life in the body and that it was impossible that it continued to be produced.  

So.......I hope you find some "cause" in the docs suggestions.  If you do not, however, then you'll be looking at the way your heart responds to exercise. What could cause that?
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Avatar universal
Thanks, doc.

SO--

Today I'm asking my GP to order a thyroid panel and also an electrolyte panel.

Meanwhile I'm going to keep exercising and try not to worry about my pulse, providing I always have one. ;-)

I'll let everyone know what the results of the tests are.

Have a great day!

Mel
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Avatar universal
jdm
In my case the doctors point to my normal sinus rhythm and otherwise healthy heart and tell me not to worry about it.  In my case the elevated heart rate after exercise or eating becomes my baseline pulse until it gradually returns to normal.  This means that if my pulse is 110 after a meal and I walk up a flight of stairs it goes to 120 0r 130-an appropriate pbm increase but really fast due to the starting point.  

Taking my small dose of attenolol an hour or so prior to eating causes my heart to behave "normally" and increase to 74 to 80 for a period of time as my metabolism picks up.  

What I get from the doctors is that my heart is just "sensitive" to stimulation-like food and exercise!  Commenting on an earlier post I think that I may have had this condition much earlier and just discovered it at a point in time.  I do believe that it has become much more pronounced as I get older.  

Perhaps attenolol would help you with the problem as it has me.  I'd say ask your doctor.  I have not been called nuts but have been accused of somehow causing the condition as a result of being preoccupied with my heart function.  Unfortunately this is just not the case.  The cause and effect of food and exercise are just always present.  I also became hypersensitive to caffeine and have cut it from my diet years ago.  

The problem with taking attenolol is that the side effects might be significant AND it just masks the symptoms and does not correct the root cause OR even identify it.  

The anxiety is worsened much for me because the doctors cannot tell me why this is happening to me.  

good luck, I know how you feel.  

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Avatar universal
Mel22,

Thanks for the post.

Explaining your new lesser heart rate recovery by a change in something intrinsic to your heart is difficult.

Changes in thyroid levels or dehydration, however, are both great explanations for why your heart rate might be somewhat higher after exercise, irregardless of blood pressure.  Couple either one of those factors with "panic" and you've got an easy recipe for tachycardia.

Try increasing your fluid intake, and then, failing that, having your thyorid level assessed.

Hope that helps.



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Avatar universal
Maybe it is more common than we think.
Maybe some people just don't notice.

In my case, I need to sort out the possibilites of dehydration and/or hyperthyroidism. I want the doc's opinion on this.

2 years ago I had a stress echo and everything was fine, although I had "trace" everything, but so does 80% of the population. I accept that my heart is basically structurally sound. I really think anxiety can play a large part in all of this. And I think less anxious people experience some of the same symptoms we do but go about their lives. But I do always want to be careful, so that's why I'll take the time to investigate. But I will not spend the rest of my life waiting for my heart to fail me--In the past I've spent too much time worrying over PVCs to the point of panic attacks, and that really was waste of time. Now I accept PVCs, take my magnesium and it's not an issue for me.

This latest "twist" needs some investigation, and then I'll deal with it.

Anyway, still waiting for the doc to chime in! ;-)

Good luck to everyone!
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Avatar universal
I'm a 40 y/o male who had been exercising regularly 3-4 x/ week.  After a workout in August, I noticed that my hr did not come down to resting rate 60-65, but remained elevated at approx 100 bpm.  Later that evening I woke up with a very fast rate 140.  I went for testing and was told it was sinus tachycardia.  This made me very anxious about returning to exercise, so I took some time off.  Since then I have tried to exercise 3 times-  each time as my hr exceeded 120-125, it then increases suddenly to 150-170, and remained elevated for approx. 15 minutes.  It now seems as though the exercise is triggering the tachycardia.  Now I'm afraid to raise my hr with any physiacl activity. I'm scheduled for another appt w/ my cardiologist for further tests.
I'm not sure if this is common or not?
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Avatar universal
Hi,
I have the same thing happen to me after I eat.  My heart races for a good 2 hours or more (anywhere from 100 -130 bpm) I was wondering if ur doc ever addressed this, because mine thinks i'm nuts.  this is very worrying to me.  I have lost over 20 pounds in the last 2 and half months cause its gotten to where Im afraid to eat!!
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Avatar universal
Hello,

I am 35 years old and up until a year ago, I was running and working out fairly regularly.  I stopped because during a run one morning last December, I felt a fluttering sensation in my heart and after a couple more short runs, decided to have a stress test.  

The results, Non-sustained Ventricular Tachycardia and PVC's.  I had undergone an extensive MRI test because my Echo results showed a slightly enlarged right ventricle, but fortunately, they were able to rule out ARVD, (Athletic heart).  The EP Study could not trigger the PVC's despite the drugs they induced to get my heartrate up.  (I was also sedated just before the procedure; Should that have been done if trying to induce PVCs?).  

Now I've dealt w/ the occasional PVC for about 7 years before all of this occured but not to this extent.  I am currently taking Covera HS which helps contol the number of PVC's during normal activity, but once my heartrate exceeds 100 bpm's, my PVC's act up and if I run, I know the v-tach rhythm will kick in.  Another doctor I consulted with recommended I go to a cardiologist who specializes in ablations for patients dealing with RVOT.  Thoughts on this or another EP Study?  Also, is there other medication that will allow me to start running again?  I miss running...alot!  Especially if I'm trying to control and combat my elevated cholesterol naturally.

Thanks,
Mike
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Avatar universal
I'm female, 42.

Good luck to you, jdm.
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jdm
You didn't give your age.  I was about 35 when I noticed exactly what you describe.  I had been a runner and VERY active in strenuous activities like backpacking in the mountains.  I watched my pulse and it returned to normal rapidly.  I noticed the elevated pulse on evenings I ran after dinner.  My moderate one hour run ( 140-152 pulse ) would be 8-9pm.  In bed at 11pm or so I noticed that my pulse was still over 100.  This was the beginning in 1985.  

The condition became progressively much more pronounced.  A strenuous hike or climb would result in a pulse of 125 normal rhythm for 4-5 hours and it would gradually drop over 12 hours!

I no longer run, hike, climb, bike or anything much.  I developed very severe anxiety reactions to the tachycardia.  Early on the doctors at my HMO told me it was mental or that it would not harm me.  Running was my way to deal with severe depression among other things.  

My pulse was described at "vagal".  It increased and decreased as I breathed among other oddities.  A stress test in 1984 found no abnormalities.  In 1996 minor insufficiency of my aortic and pulmonary valves was found on echo.  They recheck this and have told me now to worry.  It added to the anxiety.  

Now, with this forum and many other internel "learning" sources I see that I must have some sort of ectopic atrial pacing going on.  The doctors don's see anything on a standard ECG.  Just normal sinus rhythm even when it it elevated.  

I have found some correlation in the sources that refer to this condition among atheletes.  High levels of exercise may change the valves somehow and this could cause ectopic sites to become active.  

The condition basically ruined my life and left me aware of every heartbeat.  The anxiety has generalized and now it can be triggered by non heart related events.  I don't mean to whine but it's what happened.  

If you are young and active I urge you to get to the root cause of this problem.  It you progress as I have it won't get any better.  

For several years now I have been taking attenolol 25 mg a day.  My BP is very good for my age and there is no evidence or coronary artery disease though no angiograms or EP studies have been done.  I am VERY sensitive to the attenolol.  I take 1/4 tablet 4 x a day.  This permits me to have a somewhat normal life along with taking antidepressants and anti anxiety rx drugs.  

The attenolol changed my pulse so that it does not now vary with my breathing.  It dramatically reduces my ability to exercise.  The doctors just tell me that I am not taking enough to make much difference.  One ER doc told me he takes 50 mg for his high BP and doesn't feel it at all.  25 mg in one dose turns me into a zombie.  

Lastly, along with the elevated pulse following exercise I have for years had elevation following meals.  Into the 100-115 range for several hours.  If I exercise soon after a meal it is much worse.  I now know that ablation therapy, mapping etc. might have helped me.  The HMO did not want to spend the money.  It was just my life.  

Now any major diagnostic procedure like that would doubless require total sedation due to the extreme anxiety.  

I was not smart.  Twenty years ago I should have sold my home or taken out a loan and gone to a place like Cleveland where they would have probably found the cause and possibly dealt with it successfully.  

Good luck and whatever happens don't let them tell you it is no big thing or "all in your head".
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Avatar universal
jdm
It occurred to me that exercise does properly induce tachycardia!  There is an appropriate level of pulse for output of physical work based on age and condition etc.  In my case I was "healthy" in all measureable respects but my pulse began to remain elevated significantly for long periods following exercise when I was at rest.  The doctors always said that a measure of heart health or condition is how fast your pulse returns to normal following exercise.  By that measure my heart started to be very unhealthy in my mid thirties.  However, the doctors just kept telling me I was just FINE!  Hey Hank...what's athletic heart by definition?
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