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Exersize Induced Arrhythmia
I am a 45 yr old male, very fit marathon runner who experienced a very scary rapid heart rate during a workout back in January 2008. My pulse went to, I would estimate, over 200 bpm and I felt as though I would pass out, had tightness in my upper chest and jaw, the episode lasted about 5 - 7 minutes then my HR returned to normal. Was referred to a cardiolgist from my family doc, they performed an echo, and then a stress test. They said all was normal. I was a frequent blood donor in the year prior to this episode, and slightily anemic, to which seemed a logical explanation of this event coupled with my endurance training.
I experienced no other episodes after this and resumed my normal rigorous training. About 2 months ago I experienced the same thing although seemed more intense, and lasted longer and left me feeling wasted afterwards.
I went back to my original cardiologist, he performed an ekg, said it was slightly different than the previous tests, but told me not to worry, prescribed me Atenolol and told me to take low dose aspiring daily and reduce my exersize by 20%. I thus proceeded to read up on atenolol and decided I did not want to deal with the side effects. I have continued to exersize, although not as intensely, and have experienced a myriad of symptoms, although not as intense as the previous episodes. I have had 2 occasions where my HR went to 180+/-, but I was able to get it back down failry quickly - 2-3 minutes, and I felt ok afterwards. Also, I have had frequent pressure in the center of my chest, felt nauseaus, dizzy and lightheaded almost every workout - both cardio and weights.
So, I proceeded to see another cardiologist. They performed a stress echo, got my HR to 170 with no arrhythia, but he noticed my right ventricle was slightly enlarged. He suggested a cardiac MRI. He received the results and it the doc who reviewd the MRI said the both ventricles are abnormal and there appears to be scarring in my right ventricle.
He then suggested a heart cath to rule out coranary artery disease, which I have not had done yet, and prescribe Coreg cr to help with the damaged heart muscle.
Again, I am hesitant to take beta blockers as my resting pulse is < 55 bpm and I do not have high bp.
My question is a general one on my condition, any comments on potential causes and suggestions on where I go from here? Do I continue to exersize given the symptoms I experience every time I work out?
I just need some help. Thanks.
I experienced no other episodes after this and resumed my normal rigorous training. About 2 months ago I experienced the same thing although seemed more intense, and lasted longer and left me feeling wasted afterwards.
I went back to my original cardiologist, he performed an ekg, said it was slightly different than the previous tests, but told me not to worry, prescribed me Atenolol and told me to take low dose aspiring daily and reduce my exersize by 20%. I thus proceeded to read up on atenolol and decided I did not want to deal with the side effects. I have continued to exersize, although not as intensely, and have experienced a myriad of symptoms, although not as intense as the previous episodes. I have had 2 occasions where my HR went to 180+/-, but I was able to get it back down failry quickly - 2-3 minutes, and I felt ok afterwards. Also, I have had frequent pressure in the center of my chest, felt nauseaus, dizzy and lightheaded almost every workout - both cardio and weights.
So, I proceeded to see another cardiologist. They performed a stress echo, got my HR to 170 with no arrhythia, but he noticed my right ventricle was slightly enlarged. He suggested a cardiac MRI. He received the results and it the doc who reviewd the MRI said the both ventricles are abnormal and there appears to be scarring in my right ventricle.
He then suggested a heart cath to rule out coranary artery disease, which I have not had done yet, and prescribe Coreg cr to help with the damaged heart muscle.
Again, I am hesitant to take beta blockers as my resting pulse is < 55 bpm and I do not have high bp.
My question is a general one on my condition, any comments on potential causes and suggestions on where I go from here? Do I continue to exersize given the symptoms I experience every time I work out?
I just need some help. Thanks.
Hi. I am a 38yo female, and have been a fitness instructor for 16years, until a sudden stop to exercise completely due to cardiomyopathy, albeit only early. I also experience arrythmia, and many of the other symptoms you wrote of. I can understand your concerns about the HR...my resting HR was 48 at the time of diagnosis. I take Toprol and Perinophril, and after an adjustment period my resting HR remained very close to the non-drugged one! However, I have found exercise, even minor, makes my symptoms become very problematic and so have had to have a drastic lifestyle change. It can be hard to accept advice when its not want we want to hear, but I really believe that our doctors have our sustained life and our best interests at heart, if you'll pardon the pun! Keep yourself happy, stay involved in your treatments, seek advice and information from more than one source, and trust your instinct to survive. Also, enjoy the life you have as much as you can :) Best wishes!
Hi cjwfit,
Thanks for taking the time to respond. Regarding my prescribed dosage of Atenolol, it is 25mg once a day, from my original cardiologist. The second cardologist I saw actually prescribed Corteg CR, 10mg once a day.
As far as the cause of the tachycardia, neither doc could give me a reason. The second guy I saw - who also happens to be friend, so I believe I am getting good care - said the findings of the MRI indicate abnormalities of both left and right ventricles, with scarring on the right. He suggested a heart cath to rule out CAD, which I am having done next week. I think he indicated that if scarring is present and there is a weakening of the heart muscle, it could lead to the tachycardia.
Neither doctor suggested I give up exercise completely. The first guy suggested a 20% reduction and the second doc told me to take it easy, no marathons! I think I am probably pushing too hard as I don't want to accept what's happening. Like you, it seems to hit when I am lifting strenuously or when my HR goes over 140+/- for more than 15-20 minutes - basically when I am pushing myself. However, I also think I can talk myself into a rapid HR on occasions as I can perseverate on the issue at times. I find that if I get lost in other thoughts it doesn't seem so prevelant, but I could be in denial! Eliminating caffeine and sugar also seem to help.
Thanks for taking the time to respond. Regarding my prescribed dosage of Atenolol, it is 25mg once a day, from my original cardiologist. The second cardologist I saw actually prescribed Corteg CR, 10mg once a day.
As far as the cause of the tachycardia, neither doc could give me a reason. The second guy I saw - who also happens to be friend, so I believe I am getting good care - said the findings of the MRI indicate abnormalities of both left and right ventricles, with scarring on the right. He suggested a heart cath to rule out CAD, which I am having done next week. I think he indicated that if scarring is present and there is a weakening of the heart muscle, it could lead to the tachycardia.
Neither doctor suggested I give up exercise completely. The first guy suggested a 20% reduction and the second doc told me to take it easy, no marathons! I think I am probably pushing too hard as I don't want to accept what's happening. Like you, it seems to hit when I am lifting strenuously or when my HR goes over 140+/- for more than 15-20 minutes - basically when I am pushing myself. However, I also think I can talk myself into a rapid HR on occasions as I can perseverate on the issue at times. I find that if I get lost in other thoughts it doesn't seem so prevelant, but I could be in denial! Eliminating caffeine and sugar also seem to help.
Like rr2465, I am not a marathon runner, but I am in the field of exercise phys and have issues with premature atrial contractions and tachycardia. I have seen two different cardiologists in the last year--the most recent has prescribed me Atenolol, but I have not yet started taking it. I was concerned about my BP going low as well and was told to contact the cardiologist if I had feelings of lightheadedness to call and they would adjust the meds. Were you prescribed a high dosage?
I think it was wise to get a second opinion, but I think you should ask your cardiologist what he/she thinks the causes might be? There may not be an explanation--there wasn't with my issues--but it doesn't hurt to ask the cardiologist or another trusted health professional.
As far as continuing to exercise, have you been told by either cardiologist to stop completely? Are you getting this runs of tachycardia at a certain time of day, after a particular meal, during the same point in your workouts? Mine is triggered for sure by weight training--particularly if it's even a tiny bit strenuous--and if my heart rate goes up above a certain rate. Have you noticed a pattern like this? I know it's a lot of questions, but with exercise, there is no such thing as too much information for a trainer!
I think it was wise to get a second opinion, but I think you should ask your cardiologist what he/she thinks the causes might be? There may not be an explanation--there wasn't with my issues--but it doesn't hurt to ask the cardiologist or another trusted health professional.
As far as continuing to exercise, have you been told by either cardiologist to stop completely? Are you getting this runs of tachycardia at a certain time of day, after a particular meal, during the same point in your workouts? Mine is triggered for sure by weight training--particularly if it's even a tiny bit strenuous--and if my heart rate goes up above a certain rate. Have you noticed a pattern like this? I know it's a lot of questions, but with exercise, there is no such thing as too much information for a trainer!
Hi mtr614 - I'm not a marathon runner by any stretch but I exercise regularly (biking, running and surfing), I'm 36, good heart plumbing, etc. I was experiencing very high heart rate spikes during and sometimes after workouts. My resting HR is around 60-70, during exercise around 170 when I push it and I was getting spikes up to 250 every couple of months. The spikes to 250 would last anywhere from 5 minutes to an hour and I would be lightheaded, dizzy and short of breath. The cardiologist gave me an event monitor so that when I had one of these spikes they could record it. If you have enlarged ventricles you probably have something different than I do, but I can tell you that the side effects from the beta blockers they initially put me on were worse than the tachycardia itself. Everybody reacts to them a little different but it was tough telling my cardiologist that taking beta blockers and compromising my lifestyle wasn't the result I was looking for. Let us know how it works out.
Welcome to the crazy world of Heart irregularities. After running marathons in 2.37 in my mid 40's to two MI's and quad CABG in my mid 60's I live with sword of Damoclese hanging over my head.
35 years of running has been no insurance to this dilema.I now run 40 slow miles per week (on Beta Blockers) and regularly experience your symptoms(HRM readings of 225+). Medical profession's stance is sit back no your couch and relax and be satisfied with that at 67. Will not let me stop BB's or explain why!!!! So I belt out 40 miles per week and just wonder if my heart will give out. If it does, so be it as I wont stop running.
My resting pulse rate is 35 and I am still on BB's. My advice is leave the weights alone for a while and see what effect that has. Also make sure you are not Carb deficient as that has triggered my arrithymias (any stress, emotional or physical). But having said that, even when I think I have had a normal run, when I interogate my HRM there is always an excessive max HR reading (220+)
Good luck
35 years of running has been no insurance to this dilema.I now run 40 slow miles per week (on Beta Blockers) and regularly experience your symptoms(HRM readings of 225+). Medical profession's stance is sit back no your couch and relax and be satisfied with that at 67. Will not let me stop BB's or explain why!!!! So I belt out 40 miles per week and just wonder if my heart will give out. If it does, so be it as I wont stop running.
My resting pulse rate is 35 and I am still on BB's. My advice is leave the weights alone for a while and see what effect that has. Also make sure you are not Carb deficient as that has triggered my arrithymias (any stress, emotional or physical). But having said that, even when I think I have had a normal run, when I interogate my HRM there is always an excessive max HR reading (220+)
Good luck
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