Tachycardia during exercise

[JamesAA]

I'm an in shape, 36 year old.  I've been athletic all of my life.  I've played competitive tennis for a few years now but just 1-2 years ago I started feeling more and more out of breath/exhausted immediately after a length and/or intense rally w/a lot of running and heavy hitting strokes.  My heart rate sores to near max for my age 175 bpm.  My resting HR is fairly normal (62 bpm).  I also sometimes feel a bit winded after walking up a couple flights of stairs.  This is all new and weird for me since I've never experienced this before and I am still very much active w/exercise (minimum of 3 days per week of 45 min cardio sessions where I go for 85-90% of max heart rate as my target zone).  So why am I getting winded?  8 years ago I could run for days.  My cardio workouts actually feel normal.  The other time I notice this is when I do (heavy weight) squats.  After my 5th rep and I rack the weights I need a few seconds to let my heart settle. Again, it soars to 175 bpm within seconds.  Oddly this doesn't happen with bench press, or curls, or any other weightlifting routine....just with squats.

So my question is this--can this all be happening due to my getting older or is it possible that something more serious is going on with my ticker and/or lungs?  I also get PVCs on occasion.  They tend to come and go. Some days (even weeks) I get virtually none, other days (or weeks) I'll get several hundred to 1,000 per day.  My doc seems to think they aren't dangerous.  I have had holter tests, EKG, and and ECG--ECG was 3 years ago but according to him (my Dr.) my heart wouldn't have changed much structurally in 3 years.  The only abnormality they found 3 yrs ago in the ECG was a very mild leak (mitral regurgitation or something like that--forgot exact term).  He said it's fairly common and that mine was not severe at all.  

Any advice or thoughts and insight would be highly appreciated.

Thank you,
James

[flaab]

Hi James!

I just had an episode about this and your description fits mine in almost every way. I am 32 years old and was a competitive swimmer when I was younger, activity I paired with surfing. Now I only surf and do crossfit. I am overall very healthy, I have never smoked or consumed alcohol or any drug at all, I sleep well, I don't eat junk food and I exercise 4-5 days a week.

It all started three days ago. I had a sudden tachicardia episode when running 10 km. My heart rate just switched from my normal running rythm to an abnormal, super-fast rythm and I had to stop and sit down until it normalized. Took about a minute to normalize or so and in the meantime I felt dizzy, shortness of breath and felt my heart pumping.  

A bit later I started having PVCs some days. I still do. I can be months without a single one, and then it starts again for a few days. I went to the doctor and they did a 24-hour holter and an MRI of the heart, and found nothing abnormal. They even told me I had a very healthy heart.

Later, I had 3 or 4 episodes more of tachicardia since then, and all of them during exercise. They happen almost randomly, unrelated to the intensity of the exercise. And normally when the exercise requires sudden changes in body position (box jumps up and down for instance, or being laid down in the ground and having to get up quicly and sprint, or duck diving below breaking waves). I just had another one surfing today, had to sit there in the lineup and wait until my heart rate normalized: took 90 seconds or so.

When this happens, I have to just sit and wait for one or two minutes until it normalizes. Then I can even continue the exercise. It is very very weird and I would like to be able to exercise without fear.

[jh71]

Your situation is incredibly similar to mine, right down to the sports & activities.  I am 41, former college and lifelong competitve tennis player.  I have always been prone to fatigue and rapid heartrate in hot conditions.  However for about the last year I am not able to make it even thru a single long tough rally without my HR going up to 130-140 and up.  Actually it doesn't even take that tough a rally to trigger the spike.  130-140 may not sound that high but it is accompanied by severe weakness.  Last tournament match I played I had to default 2 points from winning b/c I literally was too weak to stand up.  (Lying flat on my back is about the only way to get relief).  LIke you I can tolerate gym workouts reasonably well but climbing staircases or doing exercises that simulate stair climbing cause the same thing...rapid pulse and weakness...that takes a while to normalize.  I have had multiple heart workups...won't list them all but including stress echo, Holter..all normal.  I do not get any arrythmia, just fast HR (no SVT).  Starting to investigate dysautomia as I do have a history of fainting and a + tilt table test.  I cannot believe/accept that this is just from getting older...I can accept some slippage in performance, but not like this....this is not normal.  This issue aside I would say I am definitely in above average shape for my age.

Wonder if your symptoms have changed (improved)?  I am trying to stay optimistic but it is very frustrating and certainly doesn't appear to be something that is just going to get better on its own.

[tom_h]

"....all of a sudden.". This is a key symptom.  If your heart rate "suddenly" jumps to over 180 in seemingly an instant, this is a symptom of supraventricular tachycardia or SVT aka PSVT.  Another key symptom is it suddenly converting to a slower rate, perhaps not a resting rate, buy a rate much slower than what it was a moment before.  SVT is fairlly common, usually benign, but troublesome condition as it interferes with daily lifestyle.  Let me caution that it's hard to say if that is what you experienced.  A physician should be informed, especially of you experience this again.  SVT is an electrical condition, and I don't think it's typically associated with structural issues.  Another thing to note is an EKG of a healthy heart will often show absolutely nothing.  The key is obtaining an EKG while you're having an episode.  If it becomes an event that happens frequently, quite often a 30 day monitor is prescribed which is worth until an event is recorded.  Once proof is established, a plan can be implemented,to control by drug therapy or undergo a procedure where the problem is located within the heart and deactivated.  For now, be on the lookout for it.  Quite often, if you get in once, you'll experience it again.  I hadit for 54 years and finally opted to get it permanently fixed.

[Tom0610]

I'm a 57yo male and had a weird episode on the treadmill today.  After about 50 minutes at 4mph, my heart rate all of a sudden jumped from 130 to 210.  The heartrate monitor on the treadmill freaked and starting flashing all red and yellow.  I also felt a very mild cramping up under my left collar bone.  After I slowed down to 2.5mp the heart rate stayed high.  Then it slowed after I stopped, to below 100.  Is this something I should be concerned about?  I have been diagnosed with a mild aortic stenosus (heart murmur).  I feel fine this evening.

[JamesAA]

I can't imagine all ever fell totally comfortable during a nasty string either.  

[itdood]

Good advise Jerry, you are right.  

James, I've never gotten used to episodes.  When they string together for hours on end it's not a good thing.

[JamesAA]

Thank you Jerry.  Priceless advice!  As for your results itood, congrats!  That is very good news!!!  Incidentally single flip flops (PVCs) don't really bother me anymore either.  It's the ongoing ones that bug me, but maybe someday I'll get used to those.  

[Jerry_NJ]

Hey, I'm 70 and best I can recall I wasn't getting older, I was getting better in my 40s through early 60s.  But then I was a smoker up to about age 40 when I finally got the message and quit smoking and started exercising, including running.  And I did indeed get better with each passing year for the first 10 at least... could run further and faster for one measure. But I didn't have any heart symptoms that I was aware of until about age 55, when atrial fibrillation come to live with me.  Now I feel old, and well that isn't so bad I am old and get all the senior discounts and "respect".

My only point, if I have one, is you guys are still young... build on the good days and tell yourselves you are getting better.

Good luck,

[itdood]

Couldn't find anything wrong on my test. I also was checked for CAD.  My Father had a maasive MI when he was 42 and almost died.  He had a heart transplant back in 1988 and he's still doing great, we just had lunch together.    So Iaske for extensive CAD workup.  The cardiac MRI is reallt good at checking for clogs.  I was 0%.  which surprised the heck out of, I expected some.

All my measurements are good, muscle motion is excellent, ejection fraction is excellent.  I also went for 2nd opinions.

While I was having lunch I had a HUGE flip flop.  Hadn't had one in a while.  Singles don't bother me at all.  I turned to my pop and wife and say, wow, just had a huge flip flop.  My dad said "yea I get those too even with the new heart".  We all shrugged it off and enjoyed the day.

I also had

[JamesAA]

Hi itdood.  Wow, our stories do sound extremely similar.  Funny thing is, like you I thought I could be one of those super athletes that could easily play just as competitively well into my 40s.  Well I'm not 40 yet and life has already showed me that that is not going to happen. LOL  I also now see why there are so few tennis pros over 30.  I had so much energy/stamina as little as 6-7 years ago (age 29-30).  Also, like you, some days are much better than others with regard to running/athletics.  I still have moments of feeling 25 again.  But some days I feel 75 out there, lol..just depends on the day.  

So your Dr and/or cardiologist(s) have told you that you are "ok?"  

Thank you for responding.  Knowing there are others out there with similar stories is extremely helpful, especially given the fact that you have been evaluated by professional medics.  To me, that's as valuable, if not more so, then me simply going to 1 doctor. I appreciate your reply very much.

Thanks and enjoy your weekend,
James

[itdood]

Hi James, this all sounds veryyyyy similar to my history.  I've searched high and low, many many medical tests including an advanced cardiac MRI.  I've found no answers.  I chalk it up to age.  I'm 42 now, I can understand why not too many professional athletes are in their 40s.  When I was younger I didn't give much thought to why people didn't dominate sports when they got past mid 30s, it was just a natural thing.  But now that I'm there, I understand.  I guess somehow I didn't think it would happen to me (aging).  HAH!  was I wrong.

Some days I feel stronger than others.  Like right now I can run around like I was 19.  Other days not so much.  It goes up and down.

Other stuff I mirror are that my PVCs come and go.  Same findings on my echo, with the mild regurge.  I was told the same thing, my regurge was in the average zone for my age.

Sorry, I don't have any other answers.  I tried really hard to find one.  My attitude has changed dramtically about it though.  I treasure my good days.  I keep trying different things to help myself.    Don't let it get you down, put it out of your mind.