Maybe ARVD?

[my3reasons]

I am 38yr female. 20 lbs overwt. Exercise regularly(5 days wk). Aerobics, kickboxing, wt. train, spinning, machines. My heart rate is around 70 resting. Goes to 130 in 2 min. exercise & often up to 188 in few minutes. For the past 4 months during exercise I have been getting pain (burning squeezing) in the center of my chest below/behind my ribcage. I get dizzy sometimes, but can breath. Feel weak. This doesn't happen always, but often during kickboxing. I have had to stop, but not always. 1st time to Dr. in 2 yrs. In Jan. did EKG, Stress Test/w contrast, Echo., CT scan, blood work. All normal. Last wk did Holter Monitor and did have an episode. No results yet. Dr. said a good hr during exercise would be 130-140. On the stress test after 9 min. I was told to stop. HR was 169 & bp 130/70. Incline was 4 speed 4.4. Had to stop because bp never changed? Said I did good for someone just starting to workout. I have been exercising for over 2 yrs! Didn't before that and have lost 45 lbs. History-parents have heart disease.  Diagnosed in their 60's and diabetes and high bp 40's. I have benign thyroid cysts. I don't smoke or drink on no meds. No caffiene. My questions are:

1.What should my heart rate be at rest & during exercise? Should mine be lower then 180's during workouts, since I have done this so long?
2.Why would bp not go up during stress test and why does it matter?
3. No family history of ARVD, but could I have this and if so what is treatment?
4.What else do you think this could be? Any other tests? Any info would be apreciated.

Thank you so much for your help!

[CCF-M.D.-BJ]

Hello,

first of all, congratulations on losing the weight and commiting yourself to improve your fitness.

1.What should my heart rate be at rest & during exercise? Should mine be lower then 180's during workouts, since I have done this so long?

Heart rates at rest vary.  People with very good cardiovascular fitness sometimes have heart rates of 40-80.  Overall, a normal resting heart rate should be less than 100.

During exercise there is significant variability as to home much heart rates increase and it doesn't always have to do with how fit you are but it usually does.  If you aren't in very good shape, your heart rate will probably increase faster.


2.Why would bp not go up during stress test and why does it matter?

It matters if your blood pressure drop during a stress test.  I am not sure what the issue was that made them stop your test.  I would ask your doctor directly.

3. No family history of ARVD, but could I have this and if so what is treatment?

There is nothing in your history above to make me think you have ARVD -- nothing.  Don't over think this.  Wait until you see you doctor before working yourself up about the unknown.  If it is really bothering you, call your doctors office and let them know. See if they can see you sooner.  If it was really an emergency, they would have sent you to the ER or arrange fast follow-up.

I don't mean to belittle your

4.What else do you think this could be? Any other tests? Any info would be apreciated.

The critical missing information is what happened on the holter monitor.  It is reasonable to work up these episodes to see what is happening.  It is possible you have some form of arrhythmia.  ARVD is very rare.  You are much more likely to have one of many treated conditions that causes dizziness or lightheadedness.

The best advice I have to is to take a deep breath and wait until you find out the results of the holter.

I hope this helps and thanks for posting.

[wmac]

Why do you think it maybe ARVD? Did the doc tell you that? Im no Doctor by any means but....Do you get arrthymias?? Just curious is all.
wmac

[my3reasons]

No my doctor hadn't mentioned ARVD, I just have been looking things up myself.  My dr said he thinks that my heart rate getting that high could have something to do with my problem.  I am not sure about the arrythmias.  Like I said all tests are normal so far.  Just waiting on results from Holter Moniter.  I hope to find something out from it, since I did have an episode during my class while wearing it.  I do get occassional palpatations and I do know that as soon as I get up in the morning my heart rate goes from about 70 to 95 and up.  I have a polar monitor that I have been wearing and if it is correct just sitting here now my rate is 101.  Looks like it goes from slower 96 to 104 off and on.  Just seems to change a lot and race for a few seconds sometimes.  I also check my rate at the gym using the monitors there.  Thats how I know how high it gets when I just barely do any exercise.  Walking level and going 3.0 my rate goes to 150 right away 3 minutes.  Then it just goes up and up.  Anyway, I just read about ARVD yesterday and I read that sometimes it doesn't appear until your 30's or 40's and may not show up on all the tests such as the ones I have taken.  Also that it has to do with exercise.  Right now I just want to find out what is going on.  Just looking for answers.  Thank you.

[oakroom]

It's been along time since i've looked at this site now that i'm over my ARVD scare but I thought I'd fill you in on what I went through. Last year, out of nowhere i started feeling like i had trouble breathing. went to the ER and all was fine but given my father died of a heart attack at 47, they sent me for a stress test the next day. I wasn't on the treadmill more than 30 seconds when my hr got up to 200 and my ekg was zigzagging madly. sent me for a left cath cause they were convinced i had clogged arteries. they weren't and i officially became an arrythmia patient and went to electrophysiologist. like you i did the research and found ARVD and that research was being done here in Atlanta at Emory. ARVD can only be be diagnosed with a heart biopsy. So I pushed for every test - had signal averaged EKG, MRI, echo, monitor,  everything was normal - but how does this happen out of the blue? ARVD is thought to be more common with Mediterranean decent of which I'm full -blooded Italian so when I went to Emory, Doc said it could be nothing or it could be something and the only way was to do a right heart cath and a biopsy. Had that done. All negative and normal, so i'm officially an NSVT person. I have to admit, nervous about exercising but they keep telling me to since i got the erratic hr on the treadmill. they'll monitor it...hmmm...hard to monitor if i collapse :)  anyway. i was stubborn went for the 2nd opinion, did all the tests and as long as they tell me it's not life threatening, i believe them and try not to worry about it. So, not sure about your case, but if you fit the ARVD profile, you may want to check out the web and find a clinic near you for 2nd opinion.

[Fran71]

my3reasons, when I work out sometimes my HR goes as high as 170, sometimes even 185. My trainer doesn't seem to worry at all. He says what matters most is that the heart slows down fast when I rest. I think it should decrease by at least 10 beats in the first minute of rest. I've checked mine and it had dropped by at least 20 beats in the first minute, so as I understand, it means the heart is fine.

On another note, I would like to thank everyone who posted under my question on PVC and sinus tach I asked a couple of days ago. Unfortunately it was already closed for new comments when I managed to post there. I wanted to thank everyone of you for the precious information on how NSVT or triplets feel, for writing about your experiences, and also for saying no question is irrelevant. This board is great, both for the doctors and for the participants! I'm getting lots of sympathy and understanding here. People who don't have this problem do try to sympathize, but they don't seem to fully grab how annoying and scary this can be.

Smiles everyone!

Fran

[my3reasons]

Just following up.  I did get the Holter results.  My base hr was 86 normal, but my hr was 194 while exercising during which time I was having chest burning and squeezing pain.  Called this Tachycardia.  Not sure what type.  I had no choice but to take my 3 yr old with me and of course it was hard to listen and watch him too!  Anyway, my doctor has prescribed 25mg Atenol a day and said that he believes this would be the same treatment that a cardiologist would do.  If this does not help and the pain and rapid hr continues, then he will send me to the cardiologist.  I have been taking the med for 5 days now and I have been able to exercise without getting such a high hr. and have not had the pain. Must be working!  The side effects have been rough though.  I take the med at 12pm, because I exercise around 5 or 6 pm. and from about 12:30 til 4:30 I am very tired.  It has also been a bit rough on my stomach, but I sure have felt better during my classes.  I still have a few questions to post on here as soon as I can.  It is such a busy site!  Hope to get a few more answers.

[Mudrock]

I'm a 47 year old woman who has been diagnosed with this thing called ARVD. I have never heard of if or had any heart issues that I was aware of until March 2004.  My father passed away in January of that year and I thought it was his death and I was somehow turning it all inward. You know stress.
I left from work to go to the Dr. office because just sitting at my desk I felt like I was going to pass out and I wasn't doing anything physical. My EKG was all over and they couldn't read a pulse is was so fast.
I was seen by a Cardiologist a few days later had all sorts of tests which came back with no heart problem. They put me on medication for a month or so which stopped the Tachardia. He took me off after all tests came back ok.  For 1 year and 2 months I was fine.  
On May 20th after work I went to get a hair cut, after waiting about an hour I could feel myself getting worked up or stressed out. I had felt very tired all day and had used my inhaler more than usual becaus I felt I was short of breath.
I met my husband at the local Tavern where we go on Friday's for Steak night dinner.  I had a couple of beers and my heart took off racing for over an hour and it wasn't slowing down. I asked my husband to take me home because I just didn't feel good very tired and lightheaded. He took me to the emergency room where when we walked in all I saw was a very busy night at the ER. I said I can't stay here for this I don't feel good enough to wait through this growd. Any way they assessed me right away and had me in the back room with about 6 people all over me in minutes. They were ready to knock me out and put the defibulators on me.  They injected some medication first which settled my heart down in minutes it felt like.
I had to stay in the hospital for a week having every heart test possible except a biopsy of the heart. My MRI and Electrical testing results pointed to ARVD. I now have an implanted Cardiac Defibulator (which I hate). I'm always afraid of it going off when I'm driving or while I'm at work in front of people. I don't even know what to expect if and when it does go off.