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Exercising with Inappropriate Sinus Tachycardia
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Exercising with Inappropriate Sinus Tachycardia

     Since I was 18, I have noticed times when my heart seems to "stall out" for a second or so, then "catch up" by beating really rapidly for a few beats before evening itself out.  Since these occurences cause me to feel like a large butterfly is trapped in my chest, they are always quite noticeable.  Of course, they NEVER happen when I am at the doctor's office, so it has gone untreated and unnoticed by my doctor for over 17 years.  In April, 2009, I contracted the flu.  After spending 5 days in bed with 103+ temp, I was considerably weak for several days.  I had been pretty short of breath during my illness, too, but contributed that to the flu.  Two weeks after I was better, I was still struggling with shortness of breath...feeling like I couldn't get all of the air in my lungs out, so I couldn't get enough in, either...and I noticed that my heart was POUNDING.  Pounding so hard I could see my hair move as it hung down beside my eye.  I could feel it all over...it was a panicky kind of feel.  After having an EKG and ECG from my family doctor, he ordered a Holter monitor.  The Holter monitor showed nothing except that my heartrate jumped from 70 beats per minute to 141 bpm quite suddenly for no apparent reason.  My family doctor told me that everything was normal, prescribed a beta blocker (which I couldn't take because it made me sleepy and COLD all of the time as I have almost non-existant blood pressure as it is) but I knew it wasn't and sought the advice of an arrythmia doctor.
     After wearing a 30-day event monitor for the arrythmia doctor, he diagnosed me with Inappropriate Sinus Tachycardia (IST).  He said my average heartrate during the 30 days was 120 beats per minute, with a high reading of 179 on 6/2/09 at 10:30am (which is significant to me because I know I was in a meeting...not even walking around when this reading was taken...but it was a stressful meeting).  He said that IST explained my shortness of breath, fatigue, and crazy heart rhythms, and suggested that I begin an aerobic exercise regimen of 20-60 minutes per day, 7 days per week, no matter how short of breath I am or how fast my heart beats.  He said that if the symptoms don't improve in 2 months of exercise, that we may look into treating the symptoms with medicine.  
     I have begun the exercise regimen.  My heart rate seems to get higher and higher.  The first couple of days, it peaked at 189 beats per minute, and last night it peaked at 216 beats per minute.  I was light-headed, completely out of breath, but hung in for 30 minutes till I just couldn't any longer. Now for my question...how high is too high?  Are my symptoms worsening?  Within 3 minutes of sitting down last night, my heart rate had dropped to around 96 beats per minute, and I think I felt worse in that 3 min than during the exercise.  My doctor said for me to call him before the 2 months were over if I thought I was worsening, but I don't want to call if this is what's supposed to happen, as I don't want to appear as dumb as I really am.  lol  I also don't want to have a heart attack on the gazelle exerciser in my tv room because I didn't call.  What do I do?
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well as a avid powerlifter  i can say 216 beats per min is ok but dont push yourself too hard maybe this will help

Age       50-85% average                 100% maxium effort
20 years  100–170 beats per minute 200 beats per minute
25 years  98–166 beats per minute 195 beats per minute
30 years  95–162 beats per minute 190 beats per minute
35 years  93–157 beats per minute 185 beats per minute
40 years  90–153 beats per minute 180 beats per minute
45 years  88–149 beats per minute 175 beats per minute
50 years  85–145 beats per minute 170 beats per minute
55 years  83–140 beats per minute 165 beats per minute
60 years  80–136 beats per minute 160 beats per minute
65 years  78–132 beats per minute 155 beats per minute
70 years  75–128 beats per minute 150 beats per minute

As for your results seem to be improving 96 beats per min is not bad at all considering the target range for a teenager is between 80 and 100 so your right in there  I would call the docotor to have another check up to make sure everything is ok the important thing is not to worry I know its hard really cause its like a vicious cycle the more your worry the worse it gets so you will be fine your not going to drop dead
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