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Heart Disease (Expert Forum)
Maybe ARVD Follow-Up
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Maybe ARVD Follow-Up
by my3reasons, Feb 23, 2006 12:00AM
I posted last wk. Here is a brief summary. 38yr female. Exercise 5-6 days a wk 1hr+. Had sudden burning & squeezing chest pain during exercise. Some dizzy spells and a little sick. Sometimes needed to stop, but not always just have to slow down. Stress, Ekg, Echo, blood work all normal. Wore 24hr Holter. Did not have results on last post. Do now and told I have tachycardia. Base hr was 86 during exercise went to 194. Did have BAD pain episode during exercise. Dr. said my hr is sensitive to exercise. Did not say I had to stop. Put me on 25mg Atenolol. Said he would treat me unless this doesn't solve problem and then I would need to see cardiologist for further tests. Started med last Fri. Take at 12pm and workout at 5 or 6pm. Have had a few typical side effects, tired, stomach, a little dizzy. Wear Polar monitor and hr has not gotten over 157 during exercise. Thought it was working great, but last night I did kickboxing and again had the pain. Hr was only 140. My questions:
1. What type of tachycardia would this be?
2. Should I contact Dr. about pain or give more time? Have apt. April.
3. Because I only have this pain during exercise could this be angina? Eventhough it did not show on tests. Mother does have.
4. What else could this type of pain be? Not stomach had ct.
5. Can you have tachy and angina? If so, how is it treated?
6. Is it necessary to take Atenolol everyday or could take only on days of exercise?
7. When hr is too high during exercise does it prevent wt. loss? Lost 45lbs in 2yrs need 20 more.
Thank you for your time!
1. What type of tachycardia would this be?
2. Should I contact Dr. about pain or give more time? Have apt. April.
3. Because I only have this pain during exercise could this be angina? Eventhough it did not show on tests. Mother does have.
4. What else could this type of pain be? Not stomach had ct.
5. Can you have tachy and angina? If so, how is it treated?
6. Is it necessary to take Atenolol everyday or could take only on days of exercise?
7. When hr is too high during exercise does it prevent wt. loss? Lost 45lbs in 2yrs need 20 more.
Thank you for your time!
Doctor's Answer
by CCF-M.D.-MJM, Feb 23, 2006 12:00AM
Hello,
1. What type of tachycardia would this be?
It is probably a sinus tachycardia associated with exertion. This is normal. I would have to see the holter to check for sudden onset or termination of the tachycardia or change in the morphology of the complexes to comment further.
2. Should I contact Dr. about pain or give more time? Have apt. April.
Do you mean the cardiologist or your generalist. I don't think your general practioner can do much more than what they have already done. Atypical chest pain with and without exercise is very difficult to pin point an exact cause. Sometimes the best we as cardiologist can do is tell you that the pain isn't coming from your heart and that you don't need to worry about it from a heart perspective. I suspect this is true for you but cannot comment without seeing your records.
3. Because I only have this pain during exercise could this be angina? Eventhough it did not show on tests. Mother does have.
Is it possible yes. Is it likely, NO. Your mother is a lot older than you and therefore at higher risk for coronary artery disease.
4. What else could this type of pain be? Not stomach had ct.
the differential diagnosis for chest pain probably include over 100 different things. It is very difficult to speculate. Some examples are angina, endothelial dysfunction, GERD, hiatal hernia, anxiety, costocondritis, pericarditis, pleuritis, pneumonia. Again, it is often easier to tell you what it is not than what it is.
5. Can you have tachy and angina? If so, how is it treated?
Yes can have it. Usually slowing the heart rate with a beta blocker is sufficient. If there are coronary artery blockages they can opened with stents or bypass. Microvascular angina is difficult to diagnosis and difficult to treat. You are pretty young for this. Typical risk factors are smoking, obesity, diabetes.
6. Is it necessary to take Atenolol everyday or could take only on days of exercise?
If it helps, you can use it as needed to treat you symptoms, that is if you don't have CAD and a negative stress test. You should talk to your doctor before changing his recommendation.
7. When hr is too high during exercise does it prevent wt. loss? Lost 45lbs in 2yrs need 20 more.
I think I know why you are asking this. I have seen on exercise equipement recently heart rate ranges for "fat burning." I think a good aerobic work out should include heart rates between 120 - 160 with some variation based on age. There is no absolute rule. If you heart rate is sensitive to exercise, this may be tough to precisely control.
I hope this helps. Good luck and thanks for posting.
1. What type of tachycardia would this be?
It is probably a sinus tachycardia associated with exertion. This is normal. I would have to see the holter to check for sudden onset or termination of the tachycardia or change in the morphology of the complexes to comment further.
2. Should I contact Dr. about pain or give more time? Have apt. April.
Do you mean the cardiologist or your generalist. I don't think your general practioner can do much more than what they have already done. Atypical chest pain with and without exercise is very difficult to pin point an exact cause. Sometimes the best we as cardiologist can do is tell you that the pain isn't coming from your heart and that you don't need to worry about it from a heart perspective. I suspect this is true for you but cannot comment without seeing your records.
3. Because I only have this pain during exercise could this be angina? Eventhough it did not show on tests. Mother does have.
Is it possible yes. Is it likely, NO. Your mother is a lot older than you and therefore at higher risk for coronary artery disease.
4. What else could this type of pain be? Not stomach had ct.
the differential diagnosis for chest pain probably include over 100 different things. It is very difficult to speculate. Some examples are angina, endothelial dysfunction, GERD, hiatal hernia, anxiety, costocondritis, pericarditis, pleuritis, pneumonia. Again, it is often easier to tell you what it is not than what it is.
5. Can you have tachy and angina? If so, how is it treated?
Yes can have it. Usually slowing the heart rate with a beta blocker is sufficient. If there are coronary artery blockages they can opened with stents or bypass. Microvascular angina is difficult to diagnosis and difficult to treat. You are pretty young for this. Typical risk factors are smoking, obesity, diabetes.
6. Is it necessary to take Atenolol everyday or could take only on days of exercise?
If it helps, you can use it as needed to treat you symptoms, that is if you don't have CAD and a negative stress test. You should talk to your doctor before changing his recommendation.
7. When hr is too high during exercise does it prevent wt. loss? Lost 45lbs in 2yrs need 20 more.
I think I know why you are asking this. I have seen on exercise equipement recently heart rate ranges for "fat burning." I think a good aerobic work out should include heart rates between 120 - 160 with some variation based on age. There is no absolute rule. If you heart rate is sensitive to exercise, this may be tough to precisely control.
I hope this helps. Good luck and thanks for posting.
Member Comments (2)
by my3reasons, Feb 23, 2006 12:00AM
To: Doctor
I just wanted to say that I know there is only a 2 post limit for questions per 6 months. The above questions are the last things I need to know. Hopefully everything will be resolved soon. Anyway, thank you for this great forum and your help!
