Re: Fast Heart Rate

Posted By CCF CARDIO MD-APS on January 26, 1999 at 11:15:28:

In Reply to: Fast Heart Rate posted by Deb on January 23, 1999 at 21:48:45:






At rest, my heart rate tends to vary between 85 and 105 bpm.  I have a history of benign PVCs, but they give me few if any symptoms,and I rarely even feel them anymore.  I had an echo done last year which reported some mild regurgitations and right systolic pressure slightly high (borderline normal), the echo was deemed to be within normal limits.  24 hr holter also showed PVCs but nothing dangerous.  Therefore I have been told I can exercise as much as I want...there are no restrictions at all.  My problem is that even though I have been trying to exercise, and have had some success, my heart rate goes up a lot with even mild exercise.  For example....I try to swim for the bulk of my exercise because I do have some problems with joint pain and stiffness, probably due to some kind of connective tissue disease which has not yet been able to be conclusively diagnosed.  In the water, I am only able to endure swimming 25 yds at a time, then I can walk 50 or 75 yds, then am able to swim another 25.  The people at
the YMCA are helping me develop an exercise program that will help me, I am also participating in a weight loss program there.  The instructors have been great, teaching me to better improve my strokes, and coming up with a routine that allows me to keep moving in the water for 40 - 45 minutes at a time (even though much of it is walking). I also have started to lose weight.  HOWEVER, they are not happy with my heart rate during exercise, and I also feel it is keeping me from building any kind of endurance.  In general even with just the water walking alone, my heart rate will increase to about 135 - 140 beats per minute.  Swimming one length of 25 yds causes the heart rate to go immediately to about 180 beats per minute (it does seem regular).  Walking will bring it down then to somewhere between 130 -150 bpm, but as soon as I swim another length it goes back to 180.  There is no pain, nor tightness in the chest....I do however become short of breath and have difficulty going any further at all.  I have
been completely unable to break past 25 yds swim, and I believe that the fast heart rate is hindering my progress.  As for land, I can walk a mile in about 25 minutes without my heart rate increasing much.  However, just a few minutes of basketball (by myself, throwing the ball at the basket and running around chasing the ball) is enough to kick the heart rate over 165 bpm.  As for recovery time, after swimming, after a half hour my heart rate had gone from 180 down to 135, after 2 hours it was still at 123, but tonight, several hours later, it has returned to under 100.  I have been working out with this routine for about 6 weeks, but I have been walking and doing some Nautilus type weight exercises for several months.
I am a 41 yr old woman.  PS...when I had the echo a year ago I asked the cardiologist about the fast heart rate and he said I should just ignore it since the echo was fine, and the Holter...I asked about the need for an exercise test and he said it would be completely unnecessary as my heart is fine.
Does my experience seem normal?  I am overweight, so I know I have a ways to go...I just thought by now I should see some improvement.  And it is very difficult to keep going when my heart is beating so fast.  The Y people say I should not exercise to that point, but most any real physical activity kicks it beyond the target range for aerobic conditioning.  So I don't know what to do.  Should I grit my teeth and be determined and just keep forcing myself to go on and on.  Is there a way to break this barrier?  Is the 180 bpm heartrate fast enough to make it hard for me to keep going, as I feel, or is this just something I need to try harder at?  Any suggestions are appreciated.  I really want to lose weight and gain fitness.  Thank you for all your help.
PS...thank you for previously answering questions concerning my 14 y/o with chest pain and shortness of breath, and abnormal T-waves.  She has been to the pediatric cardiologist a number of times, as well as a gastroenterologist.  A trial of Zantac has ended her pain, her last EKG was completely normal with no abnormal waves at all, and she has been completely dismissed from cardiologists!  It appears the cause of the chest pain is either reflux or possibly simply chest wall pain since there is a possibility she has lupus and does have Graves' Disease.  The only caveat we have is that if the chest pain ever does recur as severe as it once was, she still needs to go to ER to have cardiac enzymes checked...the one test that was never done.  Other than that, she is free and clear.  She has returned to competitive swimming 5-6 days a week, 2 hours at a time, with no return of chest pain, and no shortness of breath!  Thank you for helping me understand the tests and possible causes for her problems



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Dear Deb,
You may simply be so out of shape (medical term is deconditioning) that it will take you some months to see improvement.  Aerobic exercise should make the heart rate go up and make you a little short of breath.  Your heart rate does seem to take an awfully long time to come back down to normal (less than 100 beats per minute), again this may be how deconditioned you are and it may be a heart rhythm problem.  One way that this can be sorted out is an exercise test, best bet is a metabolic stress test which tests exercise capacity from a cardiac and a metabolic standpoint (they essentially calculate the efficiency of your metabolism, i.e. of the oxygen you bring in and how well it is used by your body to provide energy during exercise.)  Find a doctor who is willing to order such a test so that you can continue and exercise program, if not better understand your exercise goals.  It is of the utmost importance to your overall health that you be able to exercise on a daily basis.  You seem very motivated and that is commendable, so seek care with a doctor who is willing to help you to maintain a daily exercise program and that motivation.  It is very important that you describe all this that you have here to the doctor you choose to see.
I hope this information is useful. Information provided in the heart forum is for
general purposes only.  Only your physician can provided specific diagnoses and therapies.
Feel free to write back with further 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.