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Heart rate skyrockets, vision blackouts during exercise
What types of tests should I be asking my doctor about?
I'm a female in my mid 20s. I am generally healthy and eat well and have a very healthy BMI. I have asthma which is exacerbated by exercise, so growing up my mom excused me from PE. I remember in high school running the mile (somewhere in the 7-8 min range) and afterwards my vision went black and I felt very lightheaded and had to lie down. Generally, I avoid aerobic exercise which is the last thing I *should* be doing.
Now I get lightheaded in the shower, sometimes to the point I am afraid I'll fall if I don't sit immediately. I have to lie down for about 5-10 mins after showering. The last time I did an aerobic exercise routine a few years ago, the machine shut off because of my heart rate. It was on a medium-low setting, I'd properly warmed up, and I'd only been on a few minutes. The gym staff freaked and said my heart rate was in heart attack range. They said my narrowing vision field was very scary and sent me to the doc.
The doc did a resting EKG several days later and said I was fine. He said the exercise machine must have been malfunctioning and my lightheadedness after the shower is from being fair-skinned. He looked at my healthy appearance, prescribed cooler showers, then sent me on my way. I'm not the type to complain and I hardly take a Tylenol, so I did as told. The problem hasn't changed, though. I want to start exercising but am scared to do so without an explanation, or even being taken seriously, about what happens when I do.
I'm fine when resting. It is when I get my heart rate up that my vision starts narrowing, my gut gets an oozy feeling, my heart beat becomes extremely hard and fast, I feel clammy and my arms and legs get shaky. If I keep pressing myself physically, my legs pretty much go numb and my vision blacks out. There is no associated anxiety or panic. I've talked to enough people to know this isn't normal. I'm going to go back to the doc.
What types of tests should I be expecting him to consider?
I'm a female in my mid 20s. I am generally healthy and eat well and have a very healthy BMI. I have asthma which is exacerbated by exercise, so growing up my mom excused me from PE. I remember in high school running the mile (somewhere in the 7-8 min range) and afterwards my vision went black and I felt very lightheaded and had to lie down. Generally, I avoid aerobic exercise which is the last thing I *should* be doing.
Now I get lightheaded in the shower, sometimes to the point I am afraid I'll fall if I don't sit immediately. I have to lie down for about 5-10 mins after showering. The last time I did an aerobic exercise routine a few years ago, the machine shut off because of my heart rate. It was on a medium-low setting, I'd properly warmed up, and I'd only been on a few minutes. The gym staff freaked and said my heart rate was in heart attack range. They said my narrowing vision field was very scary and sent me to the doc.
The doc did a resting EKG several days later and said I was fine. He said the exercise machine must have been malfunctioning and my lightheadedness after the shower is from being fair-skinned. He looked at my healthy appearance, prescribed cooler showers, then sent me on my way. I'm not the type to complain and I hardly take a Tylenol, so I did as told. The problem hasn't changed, though. I want to start exercising but am scared to do so without an explanation, or even being taken seriously, about what happens when I do.
I'm fine when resting. It is when I get my heart rate up that my vision starts narrowing, my gut gets an oozy feeling, my heart beat becomes extremely hard and fast, I feel clammy and my arms and legs get shaky. If I keep pressing myself physically, my legs pretty much go numb and my vision blacks out. There is no associated anxiety or panic. I've talked to enough people to know this isn't normal. I'm going to go back to the doc.
What types of tests should I be expecting him to consider?
I ended up going to a cardiologist (no thanks to my ex-GP who continued to say that I "looked great" and discouraged me seeking answers). I had a 24 hr holter monitor, a stress test, and an echocardiogram. The cardiologist sent me to an endocrinologist to test my thyroid and to an electrophysiologist to look more closely at my heart. I had a tilt table test and a 3 week heart monitor.
The end result for me was minor mitral valve prolapse, orthostatic hypotension, vasovagal syncope, tachycardia, and hashimoto's thyroiditis.
The primary issue causing my problems with exercise was the vasovagal syncope. My blood was visibly pooling in my legs when I exercised or became hot (like in the shower) and the lack of return blood is self-corrected by the body by causing you to faint. Then you'll be lying down and the blood pressure will return to normal. The docs see this mainly as an inconveniencing issue, calling it a "self-correcting condition." Only if you faint when doing high risk activities like driving or window washing (that was on the short list!) do they consider it a real worry. In vasovagal syncope, if you're aware of it, it is possible to keep from fainting by sitting or lying down, which I had been doing. Now that I'm aware of it, the dynamics, and my triggers, I'm able to control it much better.
As sugarpea suggested, I was encouraged to drink A LOT of water. The electrophysiologist said whatever I was already drinking could be tripled. I was also told that salt wouldn't hurt me. It increases fluid retention which increases blood pressure, which is why it is not healthy for most people. However, with my primary issue being drops in my blood pressure, and with having had a full cardiac workup so that we knew I did not have other undiagnosed heart problems, the doc said it could help me. Another doc said that at my age it was pointless because my liver and kidneys are functioning well and would just filter out the extra salt.
In hindsight, I regret having the tilt table. I had to have the out patient procedure in a hospital ($$), had to have an IV inserted (and found out that cardiology patients at my hospital are required to have the largest size needle regardless of vein size--OW!!! Can you say busted vein?), and went through the full tilt table just to be told that my symptoms were so classic that it didn't matter what the tilt table results were because it has a high false-positive/false-negative rate, so I was going to be diagnosed with vasovagal syncope no matter what. Then why did I go through such pain and expense?
Another doc tried to reclassify me as having Postural Orthostatic Tachycardia Syndrome. She explained it as a good thing, saying my heart rate increased from the POTS when my blood pressure dropped from the vasovagal syncope, which she said kept me mostly in balance. I found out that POTS is primarily viewed by doctors as a psychological problem that leads to symptomatic issues in the heart (and not in the way I experienced them so she was way off base anyway), and current thinking is it is from deconditioning. There is a huge group of women who obviously say otherwise and a few docs who are leading their charge, but this one wasn't among their ranks. She was just trying to brush me off as having it all in my head and put what she thought was a nice medical sounding name to it. I'm very glad I didn't see her first, before having the tests which clearly showed otherwise. The first thing the electrophysiologist had told me after reviewing my file was, "I know what is wrong with you. You are not crazy, you are not imagining it, and you are not going to end up in a gutter dead somewhere from it." He went on to say that there's a good chance I will "outgrow" the vasovagal syncope in my 30s or 40s.
They offered several treatment possibilities if dietary and life alterations didn't adequately control everything. I am so fed up with doctors and tests after all that that I am extremely hesitant to start anything new. The electrophysiologist has me coming in for annual exams now and I'm addressing my other health issues like the hypothyroidism which indirectly affect my heart. I'm very happy that I pushed to find out what was going on and very disappointed in how long it took and what I had to go through in order to find care for very common issues.
I hope those of you struggling will also find answers!
The end result for me was minor mitral valve prolapse, orthostatic hypotension, vasovagal syncope, tachycardia, and hashimoto's thyroiditis.
The primary issue causing my problems with exercise was the vasovagal syncope. My blood was visibly pooling in my legs when I exercised or became hot (like in the shower) and the lack of return blood is self-corrected by the body by causing you to faint. Then you'll be lying down and the blood pressure will return to normal. The docs see this mainly as an inconveniencing issue, calling it a "self-correcting condition." Only if you faint when doing high risk activities like driving or window washing (that was on the short list!) do they consider it a real worry. In vasovagal syncope, if you're aware of it, it is possible to keep from fainting by sitting or lying down, which I had been doing. Now that I'm aware of it, the dynamics, and my triggers, I'm able to control it much better.
As sugarpea suggested, I was encouraged to drink A LOT of water. The electrophysiologist said whatever I was already drinking could be tripled. I was also told that salt wouldn't hurt me. It increases fluid retention which increases blood pressure, which is why it is not healthy for most people. However, with my primary issue being drops in my blood pressure, and with having had a full cardiac workup so that we knew I did not have other undiagnosed heart problems, the doc said it could help me. Another doc said that at my age it was pointless because my liver and kidneys are functioning well and would just filter out the extra salt.
In hindsight, I regret having the tilt table. I had to have the out patient procedure in a hospital ($$), had to have an IV inserted (and found out that cardiology patients at my hospital are required to have the largest size needle regardless of vein size--OW!!! Can you say busted vein?), and went through the full tilt table just to be told that my symptoms were so classic that it didn't matter what the tilt table results were because it has a high false-positive/false-negative rate, so I was going to be diagnosed with vasovagal syncope no matter what. Then why did I go through such pain and expense?
Another doc tried to reclassify me as having Postural Orthostatic Tachycardia Syndrome. She explained it as a good thing, saying my heart rate increased from the POTS when my blood pressure dropped from the vasovagal syncope, which she said kept me mostly in balance. I found out that POTS is primarily viewed by doctors as a psychological problem that leads to symptomatic issues in the heart (and not in the way I experienced them so she was way off base anyway), and current thinking is it is from deconditioning. There is a huge group of women who obviously say otherwise and a few docs who are leading their charge, but this one wasn't among their ranks. She was just trying to brush me off as having it all in my head and put what she thought was a nice medical sounding name to it. I'm very glad I didn't see her first, before having the tests which clearly showed otherwise. The first thing the electrophysiologist had told me after reviewing my file was, "I know what is wrong with you. You are not crazy, you are not imagining it, and you are not going to end up in a gutter dead somewhere from it." He went on to say that there's a good chance I will "outgrow" the vasovagal syncope in my 30s or 40s.
They offered several treatment possibilities if dietary and life alterations didn't adequately control everything. I am so fed up with doctors and tests after all that that I am extremely hesitant to start anything new. The electrophysiologist has me coming in for annual exams now and I'm addressing my other health issues like the hypothyroidism which indirectly affect my heart. I'm very happy that I pushed to find out what was going on and very disappointed in how long it took and what I had to go through in order to find care for very common issues.
I hope those of you struggling will also find answers!
All they did to establish a heart problem was an EKG???? that's ridiculous. Most heart problems don't even register on an EKG. It sounds like some kind of blood pressure problem and could be heart related. What is your blood pressure like?
I agree with sugarpea in that a holter monitor should be worn for 24 hours but even so this is only going to be a longer version of the EKG.
I would ask if you can have an echocardiogram to check your EF etc.
I agree with sugarpea in that a holter monitor should be worn for 24 hours but even so this is only going to be a longer version of the EKG.
I would ask if you can have an echocardiogram to check your EF etc.
It sounds like you are experiencing orthostatic hypotension. I would ask your doctor for a tilt table test and a 24 hour holter monitor study. Make sure you drink A LOT of water. Like 3+ liters of water a day. That will help with your symptoms.
Best wishes sweets!
Best wishes sweets!
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