cardiopulmonary exercise stress test

[my3reasonsy]

I'm 39 female and for past 2 yrs have episodes of chest tightness, pain, & shortness of breath. Wt. 190lbs.  Only happens during workouts and not always, 2-3 a month.  Kickbox, spin & raquetball 4-5 days a week faithfully!  Stress test/thallium, echo, ekgs and blood tests normal.  Holter showed hr at 200 with pain episode.  Have taken verapamil, toprol, atenolol, nadalol, stop due to side effects.  Now on Cardizem la 180 mg daily + baby asprin for past month.  Nothing has ended episodes.  Friday did cardiopulmonary exercise stress test on treadmill.  Start at 70 hr & 118/76 bp.  Had to stop after 5 minutes due to short breath, but no pain.  May sound odd, but I would like to have reached that point so that something may have been shown.  Hr. 178 bp 178/72.   Would this be a normal response even while taking Cardizem?   Any other tests to consider?  Any input is apreciated.

[ireneo]

I was wondering the same thing. You work out a lot more often than I do and with greater intensity. Just two thoughts come to my meager mind: you mentioned your weight but not your height. If you're carrying a bit more weight than needed that could cause some fatigue. Or what about exercise induced asthma?

[my3reasonsy]

Thank you for your response.  I workout very intensely 1-3 hours 4-5 days a week every week.  My hrt rate typically increases quickly, but I keep going unless I have pain or can't breath.  Is it possible to be in poor physical condition with this much physical activity?

[Douglas Bogart, MD]

This would be a high heart rate and BP response to only 5 min of exercise.  It may be the symptoms are due to poor physical conditioning.  The cardiopulmonary stress test should give this answer.