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High HR and PVC's After Exercise
Hello everybody, I'm new here and wanted to ask a question to see if anyone was experiencing or has experienced anything like what I've been going through. I am a 31 year old male athlete (Ice Hockey and Running), 6'3" and 210 lbs, exercising daily and eating well (mostly grilled chicken and veggies when I can). I drink about a cup of coffee daily and average a beer or two a day My doctor isn't concerned about any of the above, other than my belief that I eat a bit too little and exercise a bit too much.
So, as a bit of a back story, I started having what were diagnosed as panic attacks after watching someone at work have a heart attack; I was one of the people that got him out of the building (long story, no paramedics for 35 minutes). I started having chest pain and panic attacks that were diagnosed as GERD and anxiety/stress, which seemed plausible as I do love spicy foods. Most of my panic attacks were associated with either feeling a missed heartbeat or looking up heart attack symptoms, the latter which I know is insane but continue to do.
I've heart several EKG's, two Stress Tests, blood work done which revealed marginally high total cholesterol but high LDL's (good cholesterol) and an optimal ration. All blood work came back normal, minus low levels of Bilirubin (0.1 where median range should be 0.2-1.2). All tests were optimal, so I'm being constantly told that it's due to stress and anxiety, both of which I do believe are a result of panic attacks.
I've been concerned about an elevated exercising heart rate during running, of which my doctor tells me not to worry. After a reasonably timed (8:00 mile or so) over about two miles, my heart rate will max out at about 190, but I'd imagine it averages at about 175-180. These are all taken with a HR monitor after the run. My heart rate immediately begins to decline at a steady clip until it returns to normal about 5 minutes after a run.
This week has been particularly stressful; I was away for a hockey tournament (coach) and ran two miles the first night, HR max was 197 and average was about 180 over a 7:30-8:00 clip over two miles. I was a bit concerned but chalked it up to overexertion, caffeine, and the product of a long drive.
The second night I ran about a 9:00 mile pace over two miles with my heart rate peaking at 165 and averaging about 155, a sign I took to mean that I was exerting myself too much and going too fast, which is disconcerting for a daily athlete but I figured that I understood more now.
So the problem begins here, sorry for the long read up to this point. Last night, 3/27/17, I decided to hop to an easy run, so I did 2.2 miles at what I thought was about a 8:30 minute per mile pace. I felt quite good an could've gone longer. Upon stopping, I noticed that my heart was POUNDING and was going so quickly my HR monitor wouldn't register immediately, though since it's on a cellphone it was more than likely to be a result of sweat and fog on the receptor. After stopping completely, I was able to get a reading and it had spiked to 210-215 and wouldn't slow at all. As I was taking my pulse manually, I felt my heart skip a beat and IMMEDIATELY my heart rate slowed to about 120. I had felt chest tightness during the run but nothing I'd not felt before. I was not dizzy or panicked, other than the panic of not being able to figure out what was going on, so my anxiety stepped in.
I immediately e-mailed my doctor (around 10 PM) and he responded this morning saying that now, after a year and a half of tests and not being concerned, he now had concerns and wants me to wear an Event Monitor for 6 weeks.
Can someone PLEASE help me figure out what the hell is going on? My anxiety is pretty tremendous and only exacerbated by the events of last night and the e-mail from my doctor this morning. I exercise daily and do not want to drop dead; I'm still waiting on word from my doctor on if I can exercise normally and about just what happened last night.
Thanks for any help in advance!
So, as a bit of a back story, I started having what were diagnosed as panic attacks after watching someone at work have a heart attack; I was one of the people that got him out of the building (long story, no paramedics for 35 minutes). I started having chest pain and panic attacks that were diagnosed as GERD and anxiety/stress, which seemed plausible as I do love spicy foods. Most of my panic attacks were associated with either feeling a missed heartbeat or looking up heart attack symptoms, the latter which I know is insane but continue to do.
I've heart several EKG's, two Stress Tests, blood work done which revealed marginally high total cholesterol but high LDL's (good cholesterol) and an optimal ration. All blood work came back normal, minus low levels of Bilirubin (0.1 where median range should be 0.2-1.2). All tests were optimal, so I'm being constantly told that it's due to stress and anxiety, both of which I do believe are a result of panic attacks.
I've been concerned about an elevated exercising heart rate during running, of which my doctor tells me not to worry. After a reasonably timed (8:00 mile or so) over about two miles, my heart rate will max out at about 190, but I'd imagine it averages at about 175-180. These are all taken with a HR monitor after the run. My heart rate immediately begins to decline at a steady clip until it returns to normal about 5 minutes after a run.
This week has been particularly stressful; I was away for a hockey tournament (coach) and ran two miles the first night, HR max was 197 and average was about 180 over a 7:30-8:00 clip over two miles. I was a bit concerned but chalked it up to overexertion, caffeine, and the product of a long drive.
The second night I ran about a 9:00 mile pace over two miles with my heart rate peaking at 165 and averaging about 155, a sign I took to mean that I was exerting myself too much and going too fast, which is disconcerting for a daily athlete but I figured that I understood more now.
So the problem begins here, sorry for the long read up to this point. Last night, 3/27/17, I decided to hop to an easy run, so I did 2.2 miles at what I thought was about a 8:30 minute per mile pace. I felt quite good an could've gone longer. Upon stopping, I noticed that my heart was POUNDING and was going so quickly my HR monitor wouldn't register immediately, though since it's on a cellphone it was more than likely to be a result of sweat and fog on the receptor. After stopping completely, I was able to get a reading and it had spiked to 210-215 and wouldn't slow at all. As I was taking my pulse manually, I felt my heart skip a beat and IMMEDIATELY my heart rate slowed to about 120. I had felt chest tightness during the run but nothing I'd not felt before. I was not dizzy or panicked, other than the panic of not being able to figure out what was going on, so my anxiety stepped in.
I immediately e-mailed my doctor (around 10 PM) and he responded this morning saying that now, after a year and a half of tests and not being concerned, he now had concerns and wants me to wear an Event Monitor for 6 weeks.
Can someone PLEASE help me figure out what the hell is going on? My anxiety is pretty tremendous and only exacerbated by the events of last night and the e-mail from my doctor this morning. I exercise daily and do not want to drop dead; I'm still waiting on word from my doctor on if I can exercise normally and about just what happened last night.
Thanks for any help in advance!
Your worry is understandable, but most of us here are patients like you, and we don't have enough data or medical knowledge to anticipate what your doctor will find from examining you and running an event monitor on you.
*After* that, he will have a ton of data on your heart and will be able to give an informed diagnosis.
In the meantime, take comfort from a number of facts:
1.You are young and you exercise regularly. That combo alone puts you in a low-risk category.
2. You do not describe any of the classic symptoms of true heart attack, apart from a sensation of mild (I assume) chest tightness. IOW, you didn't feel as though an elephant was sitting on your chest; you don't describe faintness or nausea; you were able to continue walking after your run; and you are not phsically disabled even now in any noticeable way.
3. You are aware that the experience of seeing someone in the grip of a heart attack may have triggered anxiety in you. That would be perfectly comprehensible, BTW, and it would explain your fear of dropping dead (which, given your history and lack of symptoms associated with mortal danger, is probably not reality-based).
4. Also, take note that your doctor did *not* order you to get to the hospital at once, and that he has not told you to come into his office immediately. I would guess that he did not feel you are in real danger now.
I would suggest that when you do speak with him, it would not hurt to ask for a short-acting anti-anxiety med like Ativan to help you during spells when you feel highly anxious but do not yet have a diagnosis regarding your heart.
*After* that, he will have a ton of data on your heart and will be able to give an informed diagnosis.
In the meantime, take comfort from a number of facts:
1.You are young and you exercise regularly. That combo alone puts you in a low-risk category.
2. You do not describe any of the classic symptoms of true heart attack, apart from a sensation of mild (I assume) chest tightness. IOW, you didn't feel as though an elephant was sitting on your chest; you don't describe faintness or nausea; you were able to continue walking after your run; and you are not phsically disabled even now in any noticeable way.
3. You are aware that the experience of seeing someone in the grip of a heart attack may have triggered anxiety in you. That would be perfectly comprehensible, BTW, and it would explain your fear of dropping dead (which, given your history and lack of symptoms associated with mortal danger, is probably not reality-based).
4. Also, take note that your doctor did *not* order you to get to the hospital at once, and that he has not told you to come into his office immediately. I would guess that he did not feel you are in real danger now.
I would suggest that when you do speak with him, it would not hurt to ask for a short-acting anti-anxiety med like Ativan to help you during spells when you feel highly anxious but do not yet have a diagnosis regarding your heart.
2 Comments
Thanks for the response! I was told to exercise normally and to live normally even after the event monitor goes on so I'm doing my best to relax and not worry.
Good plan. I would note that (a) if you are unsuccessful at 'not worrying,' or (b) you continue to worry compulsively after being told that your heart is OK (as is likely), then there are ways to treat this kind of unfounded worry.
We can talk later.
We can talk later.
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