Re: Fast Heart Rate

Posted By CCF CARDIO MD - MTR on December 09, 1998 at 22:45:05:

In Reply to: Fast Heart Rate posted by Dee on December 09, 1998 at 01:03:00:






I am an overweight 41 yr old woman...5 ft 3 in and 175 pounds...down from 195 a year ago and 185 about 2 months ago.  I have started making more of an effort to improve my general health, which has not been too good, starting by increasing exercise and cutting down on food.  I do have great b/p, and wonderful cholesteral numbers and ratio.
However, I have a high resting heart rate.  When I exercise, my heart rapidly exceeds the target rate for my age.  I do have history of benign PVCs and they don't bother me any more, having found out they are not dangerous...I also have mild regurgitation in pulmonary and mitral valves, trace pulmonic insufficiency, and borderline high/normal systolic pressure...I have been told on review of echo that these conditions should cause me NO problems and should not contribute to any symptoms.  Resting heart rate is usually in the high 90s but quite often is in the low 100s.  Mild exercise, such as walking a mile in 30 minutes, or water walking, is enough to get my heart rate in the 130s.  Heavier exercise, like swimming 25 -50 yds, or shooting baskets by myself in the gym, quickly and easily causes the heart rate to go anywhere from 165 - 185....thus approaching maximal heart rate according to my age.  The cardiologist was not interested in any of this, he said since the echo was ok, I could run a marathon if I
wanted to, and to go ahead and start any exercise program I want.  I do have many episodes of pain in my chest and sometimes my upper back...it has been called chest wall pain.  I do have undifferentiated connective tissue disease.
I enjoy the exercise, even though I tire easily and get out of breath, I can keep running around the gym playing basketball for a long time after the heart rate increases.  I can't swim long after the heart rate increases because I get so short of breath I am unable to get enough air while swimming.  Out of the water, it doesn't matter much.  Heart recovery rate is kind of slow too.
For an example, while walking in a grocery store, I stopped at the B/P machine, rested for a couple of minutes first...my B/P was 111/58, and my pulse was 110 bpm.
I keep hoping the heart rate will go down the longer I exercise and the more weight I lose, but it hasn't made a difference yet, should it start to improve.
I took a fitness test at the Y and received very poor ratings primarily due to resting heart rate and exercise heart rate.
Is it safe to continue my workouts?  Is there any problem with the heart rate being out of the target zone most of the time I am exercising and so close to the so-called maximul heart rate?
Thank you for answering my questions...You have helped me in the past and I have always found your responses to be quick and very insightful and compassionate.
Dee



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Dear Dee, thank you for your question.  There are many possibilities for your elevated resting heart rate including hyperthyroidism, deconditioning, too much caffeine, and a rare disorder called inappropriate sinus tachycardia (IST).  To rule out hyperthyroidism, a simple blood test can be performed.  Deconditioning may be playing a role in the high heart rate, but I think your heart rate should have decreased with weight loss and increased exercise.  Stimulants like caffeine and tobacco can increase the resting heart rate and should be avoided.  IST is very uncommon and is a problem with the sinus node of the heart that normally initiates the electrical beats.  From what you mention, I assume that you have a normal stress test and echocardiogram.  The mild valvular regurgitation seen on the echo is still within the normal limits.  However, since your heart rate increases so dramatically with even mild exercise, I would caution you not to exercise until you seek a second opinion.  I think your best option would be to see a cardiologist called an electrophysiologist who specializes in rhythm disorders of the heart.  Finally, you should be commended for your dedication to weight loss and proper dieting.  
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.  Good luck!
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.   The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.