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Heart Disease (Expert Forum)
Re: Fast Heart Rate
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.
Re: Fast Heart Rate
by CCF Cardio MD - MTR, Jan 01, 1995 12:00AM
Posted By CCF CARDIO MD - MTR on December 11, 1998 at 10:27:59:
In Reply to: Fast Heart Rate posted by Dee on December 11, 1998 at 01:01:14:
: I have NOT had an exercise stress test for several years. About 7 or 8 yrs ago, I had an exercise stress test by a cardiologist....he said it revealed tachycardia, triplets and runs of PVCs, both during the actual exercise and duiring the recovery phase...he put me on medication and told me it would probably need to be controlled with medication possibly for life. I moved and changed doctors. My new doctors and cardiologists did do echo on me, as you stated everything was within normal limits. So they said there was no need for medication, except dental premed, and no need to worry and no restrictions. Since I have so many symptoms during exercise, and for about 30 minutes after, I asked about an exercise test. He said it was unnecessary (the cardiologist). He questioned why I even felt the need to be seen in cardiologist office, and said a woman my age (41) very rarely would ever have anything wrong with the heart. I have had problems even getting the cardiologists to see me...most require a referral from a doctor, and my primary doctor says I don't need a cardiologist to run any tests on me. How seriously should I take this? Should I absolutely insist someone let me go to this electrophysiologist? Also, is this inappropriate sinus tachycardia a relatively benign condition...is it
worth the fight to get this diagnosis ruled out or in...are there treatments...could it be dangerous? I'm dealing with so much right now... I don't have to have a name as long as I know this is not dangerous. I am having some pain also...more like a dull pain in my midchest and upper right back...actually more like a sense of pressure than pain...it is not too bad and I can still exercise etc. Thanks for commenting on the weight loss, I have worked hard and will continue to do grath in school.
Dee Tachycardia
: 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
___
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.
_
Dear Dee, thank you for the follow-up question. I still think it would help for you to see a cardiologist, but I cannot give specific advice in this forum so you should speak to your primary care physician again. Inappropriate sinus tachycardia is not a dangerous condition, but the symptoms of resting tachycardia can certainly be a nuisance. Given that you have not had a stress test for many years, I think another stress test may help to sort out what's going on. But, again, I think you should speak to your own physicians about this. Best of luck and I hope you get some answers.
In Reply to: Fast Heart Rate posted by Dee on December 11, 1998 at 01:01:14:
: I have NOT had an exercise stress test for several years. About 7 or 8 yrs ago, I had an exercise stress test by a cardiologist....he said it revealed tachycardia, triplets and runs of PVCs, both during the actual exercise and duiring the recovery phase...he put me on medication and told me it would probably need to be controlled with medication possibly for life. I moved and changed doctors. My new doctors and cardiologists did do echo on me, as you stated everything was within normal limits. So they said there was no need for medication, except dental premed, and no need to worry and no restrictions. Since I have so many symptoms during exercise, and for about 30 minutes after, I asked about an exercise test. He said it was unnecessary (the cardiologist). He questioned why I even felt the need to be seen in cardiologist office, and said a woman my age (41) very rarely would ever have anything wrong with the heart. I have had problems even getting the cardiologists to see me...most require a referral from a doctor, and my primary doctor says I don't need a cardiologist to run any tests on me. How seriously should I take this? Should I absolutely insist someone let me go to this electrophysiologist? Also, is this inappropriate sinus tachycardia a relatively benign condition...is it
worth the fight to get this diagnosis ruled out or in...are there treatments...could it be dangerous? I'm dealing with so much right now... I don't have to have a name as long as I know this is not dangerous. I am having some pain also...more like a dull pain in my midchest and upper right back...actually more like a sense of pressure than pain...it is not too bad and I can still exercise etc. Thanks for commenting on the weight loss, I have worked hard and will continue to do grath in school.
Dee Tachycardia
: 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
___
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.
_
Dear Dee, thank you for the follow-up question. I still think it would help for you to see a cardiologist, but I cannot give specific advice in this forum so you should speak to your primary care physician again. Inappropriate sinus tachycardia is not a dangerous condition, but the symptoms of resting tachycardia can certainly be a nuisance. Given that you have not had a stress test for many years, I think another stress test may help to sort out what's going on. But, again, I think you should speak to your own physicians about this. Best of luck and I hope you get some answers.
