# Heart Issue?



## pedaler845 (Jul 18, 2004)

*Heart & Lyme Issue?*

First off -I am seeing a cardiologist later this week.

Im having an issue that has been tough to daignose: I can ride @ moderate effort for hours. If I exceed 60% of my normal effort, my heart races faster than my breathing and I need to stop for rest. Another example is I can walk briskly all day, but can't jog more than 50 feet before my heart races and I have to stop to rest.

I'm 45 and been a strong cyclist for years. This has come up a few times in the last 3 years, but seemed to go away on its own. I experience no pain and have plenty of energy. In the past I thought it was asthma. Albuterol inhaler has no effect & my breathing seems fine (I dont think its asthma). Antihistamines have no effect (I dont think its allergies). No major stress, drug abuse, family history, etc. Nothing seems to bring on the event, Ive just been maxed out at 60% of my normal effort for a month now.

Ive had Lyme & Ehrlichiosis and been treated. My symptom is limited to what Ive described: no headaches, dizziness, etc.

Any ideas?


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## Cayenne_Pepa (Dec 18, 2007)

Get a cardiac stress test done. This can tell you what your heart's ejection fraction is. See if the test(a monitored, treadmill test) is covered by your insurance plan.

I was a hardcore meth and tobacco abuser, for 22 solid years. I was diagnosed with Congestive Heart Failure(CHF) at age 42. My Ejection Fraction was a piddly 33. Doctor was a cyclist and recommended I take up Mountain Biking, once I fully stabilized and recovered from the dope addiction. Seven years later, his prognosis paid enormous dividends: I went from barely able to walk one block without gasping for air....to doing two road centuries a year. My EF is now a robust 68...and I owe it ALL to the bike....


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## thatguyat99 (May 20, 2014)

Interesting. I wonder if you are having some sort of exercise induced ventricular tachycardia. It is a good thing to see a cardiologist. They will do a baseline ECG and yes you might buy yourself a stress test. It sounds pretty benign with the lack of other symptoms. However, the heart is nothing to mess with...better to check it out. If you don't mind, post back with what your cardiologist says. I am curious as to the outcome.


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## smilinsteve (Jul 21, 2009)

Does it feel like a fast but regular heartbeat, or fluttering, flip flopping? Pounding? Racing? How would you describe it? When it happens, do you have to stop exercise due to shortness of breath, or due to the feeling in your chest?


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## pedaler845 (Jul 18, 2004)

I stop (the exercise) to rest because of the feeling in my chest, like too much exertion. My breath gets somewhat short, but isnt what stops me. After resting a minute, I pedal fine until I exceed my normal 60% output on a climb, etc.
I also am being monitored for thyroid (mine was removed 30 years ago) and taking synthetic replacement hormone tablet daily. Levels have been pretty stable, but maybe the general practioner missed something.
Glad it (somewhat) sounds benign, I will update. Appt is Friday. Thanks.


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## bakerjw (Oct 8, 2014)

Zachariah said:


> Get a cardiac stress test done. This can tell you what your heart's ejection fraction is. See if the test(a monitored, treadmill test) is covered by your insurance plan.
> 
> I was a hardcore meth and tobacco abuser, for 22 solid years. I was diagnosed with Congestive Heart Failure(CHF) at age 42. My Ejection Fraction was a piddly 33. Doctor was a cyclist and recommended I take up Mountain Biking, once I fully stabilized and recovered from the dope addiction. Seven years later, his prognosis paid enormous dividends: I went from barely able to walk one block without gasping for air....to doing two road centuries a year. My EF is now a robust 68...and I owe it ALL to the bike....


KUDOS TO YOU! I love to see people pull themselves up out an adverse situation as an example to others.

As to the OP. I like to be informed on my health, so I found a blog called the athletes heart blog out on the net. It is run by a cardiologist and he helps with all kinds of questions.

As others have mentioned, heart tests are the best tool to diagnose what is happening in your situation. A few years ago, I was feeling like I couldn't exhale completely, so my doctor had me try albuterol. Be careful with that drug. After several days, my heart started giving me PVCs and I mean a lot of PVCs. Like every third heartbeat.
After many many tests, including an angiogram, we've never been close to find out what changed to cause the behavior.

but get it checked out.


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## pedaler845 (Jul 18, 2004)

So far my ekg and bp, hr numbers look good going back 5 years. I will be having that treadnill stress test and a full bloodwork towards the end of the month. 

Thanks all for providing some very helpful feedback. The Athletes Heart Blog looks good. It has been an educational struggle to find info on my situation. "Some kind of exercise induced ventricular tachycardia" seems to be a strong lead for me to research, since before this event happened I didnt know what some of these terms meant.


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## smilinsteve (Jul 21, 2009)

So you saw the doc yesterday and he had no theory on whats going on?


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## pedaler845 (Jul 18, 2004)

Correct, but she said something to the effect of it being unlikely that I will have a serious incident based on the ekg. Thorough bloodwork next week, with the treadmill test late this month.

I looked at the Livestrong site for exercise induced tachy and I dont like the sound of having to take up golf, cricket or bowling. I just upgraded to a carbon Niner for fk sake!


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## ETChipotle (Sep 20, 2014)

Cardiology is a really difficult hobby to take up, but sometimes you just have to.

I don't think this is what takes you out of mountain biking. Or at least it shouldn't have to. Access to the proper health care is the issue. I was a pretty difficult case.


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## bakerjw (Oct 8, 2014)

ETChipotle said:


> Cardiology is a really difficult hobby to take up, but sometimes you just have to.


You are correct. When I had my angiogram a couple of years ago, I was wide awake for it. It was pretty cool to watch. My cardiologist told me that I have a unique heart as my LAD (Left Anterior Descending) artery wasn't typical. Commonly referred to as a coronary artery anomaly or CAA. He also said that he'd have to do some research and schedule a CAT-Angiography scan which would show the actual routing of the LAD.

What can happen, and is oftentimes the cause of young athletes dropping dead on the field, is that the LAD passed between the aorta and the pulmonary artery. When the heart beats, both arteries slightly enlarge and squeeze the LAD. If I had a CAA routing issue, then I'd get my chest cracked open and they'd go in and fix it.

Being a research and test engineer, I spent a week studying the structure of the heart and it's arteries and all of the nomenclature. After the CATA scan, I went to the hospital and got a copy of the results. You can do that since they are your results too btw. I read through them and understood everything.

Luckily the results were negative and I got a PA rather than my cardiologist. I showed her the results and then showed her some of the documentation that I had found on the web from some major heart universities. I ended up giving them to her so that she could use them for a lunch and learn at my cardiologists office. I got a real kick out of that.

Not trying to write a novel, but our bodies are the engines for our sport and it is in our best interest to understand as much about them as is possible. Some doctors feel threatened by that, but they usually come around and realize that an educated patient is a good thing.


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## Frodo1095 (Jul 19, 2010)

Most likely cause is atrial fibrillation.
Very common in cyclists, particularly those who have done it for a long period or have competed to a reasonable level.
Can be brought on by exercise and causes SOB, but does not cause any other major symptoms
Easiest way to try and prove would be with a heart monitor that you can wear for 24 or 48hrs and reproduce the type of exercise that normally brings it on, that way you have a heart recording both prior to, during and after symptoms to try and identify if it is a cardiac arrhythmia as the root cause.
Often in situations likes yours a stress test will not be that helpful as it is a short sharp shock designed to look for cardiac disease causing angina (can be useful to exclude as well), don't get me wrong it can still find the issue, but my preference would be to have a heart monitor and self reproduce the symptoms, that way you know the doctor is seeing exactly what is happening when you are symptomatic.
An echocardiogram would also be advantageous.


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## pedaler845 (Jul 18, 2004)

No diagnosis yet, and AF has been ruled out. Everything looks good from echo, stress test, etc. From those good results my doc is comfortable to have me push hard to reproduce the symptom while wearing a 24hr monitor.

Another way I describe my symptom: Im on a rail trail and cant pedal hard enough to get into the triple ring. My breathing might be labored but its way behind my pounding HR. Here's a detail though: After 2 months symptom has improved so that I can get the big ring; or climb a flight of stairs w/o chest pounding.

The symptom first appeared 3 years ago, lasting a few weeks then subsiding -though I may have not returned to 100%. Now, my aerobic exercise performance is about 90% of my normal of 3 years back.

About 3 years ago I'd gotten Lyme and/or a possible co-infection (could be Bartonellas). Both are known to cause palpitations. Will be seeing a "Lyme Literate MD" after the halter monitor next week. Thanks & Happy New Year.


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## pedaler845 (Jul 18, 2004)

I've postponed the 24hr monitor because the palpitations are hard to reproduce now. I expect results would be comparable to the treadmill stress test, HR @ 173bpm and nothing conclusive.

I experience my symptom now as being at about 90% of my former aerobic output, limited by heart pounding. 

Very frustrating and hard to diagnose. I will observe if the decline of symptoms continues, and pursue a "LL MD". In the meantime I am taking homeopathic remedies for detox and immune system.


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