Ultimate Test

[delanp]

I had 4 drug eluting stents placed ~ 2 1/2 years ago after a heart attack @ age 56 (male)

I now jog ~ 3 -4 times a week at ~ 7 - 8 miles/hr for ~ 30 mins....simply to check for any discomfort. None...ever. Play squash.

Don't smoke, eat sort of sensibly, standard weight.

I never have any chest discomfort..although it does 'ache' ~ 2 days after a good run...but it 'aches' and is sore to the touch..just a little.  On a scale of 0 - 10, it's a 1 or 0.5.  Very minimal.  I think this may be slight bruising of the chest muscles ??

I have regular tests..last one was August (thallium stress)..no change from a year ago.  They call it a 'normal/abnormal' ..normal for someone with stents I suppose.  Echo was fine ...said my heart was back to normal.  Had a CT64 scan ~ 1 year ago..one Dr. said nothnig thee..another said ~ 25% blocked at the end of 1 stent.

I'm paranoid.  I'm out here in the middle east where there are no private clinics.  So, I'm on my own.  The tests I get are when I visit the US.

I take Lipitor, Plavix, Aspirin, Toprol & Diovan.  Heart rate 51. BP 128/70.

Questions:

a) If I can run and experience no pain, I'm assuming the heart is getting what it needs...and I'm OK ??

b) Anything else I can do out here on my own to check myself?

c) Here's a dumb question ..if the heart is a muscle..can you strain it and would it hurt ...like a pulled leg?

d)  The toprol slows my heart down.  My running tries to speed it up.  Can toprol make running hard..toprol pulling one way and my runnnig the other way?


Regards,

Delanp (major pessimist...my glass is never even half empty ... I round it down to completely empty)

[delanp]

Jon,

I checked the numbers you suggested...after exercise running my heart rate got to 160...1 minute later is was ~140, then another 30 seconds got it down to 102. Is that good...or ?  Normal heart rate for me is 54 (Toprol!)

Regards,

Delanp

[erijon]

I know what you mean, my "anxiety" over heart disease keeps me going on the exercise routine too, I guess that's just an extra benefit to worry! Please feel free to drop me a note if I can ever help out.

Good luck,

Jon

[delanp]

Jon...thanks for the feedback.  I understand about the unstable plaque, and am just hoping if any does break loose, my pipes are open enough to let it move on.  I'll check those numbers and see what happens.. I know my systolic gets to ~ 156, but I've never checked the recovery.  Another good thing about my mind set (always negative) is that it prods me into regular exercise.

Once again thanks.

[erijon]

I can't answer all your questions, but I can tell you what my cardiologist told me about your first 2 questions as I asked them as well. I also exercise regularly, 7 days a week on a treadmill for 45 minutes, approx 4 miles. I do this for 2 reasons, one to get the exercise, but secondly in the back of my mind I fiqure if I can do this without any problems at my age (49 year old male), then the old ticker must be good. It's actually a a condition know as "checking" according to my med school son in law studying pshycology. My cardiologist said that it does mean the heart is getting enough oxygen under stress which generally means clear arteries. However, she reminded me that 70% of heart attacks are caused by unstable plaques rupturing, causing a clot and closing off an artery resulting in a heart attack. Her point was that although it is a good sign that you get no pain with exertion, it does not mean you are safe from heart attacks, especially if you have a history of your own with CAD or a family history of early onset CAD or the other main risk factors like smoking, weight, diabetes ect. One other thing you can do to check yourself and the function of your heart is to check your heart rate an blood pressure responses during exercise. You should see an increase in your heart rate and an appropriate recovery after peak exertion, you want to see your BPM drop 12 BPM in the first minute after peak exertion. Also, you want to see your systolic number increase to about 145 -170. It will level out at some point during your exercise and then may actually drop as more blood is pushed to the small arteries in your limbs to provide the proper amount of oxygen to your muscles. Your diastolic number will normally only rise a few points and will recover very quickly after exercise.

I still do it, and in the back of my mind it still helps me feel like I'm OK, but the important thing is you are getting a good arobic workout. The one thing she cautioned me on was to not exceed 85% of your maximum heart rate, there is no additional benefit and could cause a plaque to rupture, you should stay within 60 - 80% of your maximum heart rate.

Good Luck,

Jon