Pericarditis and cycling: I was... - British Heart Fou...

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Pericarditis and cycling


I was diagnosed with viral pericarditis in November 2017 aged 53. I was very fit through cycling 200 - 300km per week, yoga and rock climbing. Height 170cm weight 61kgs. It hit me hard with two hospital stays in 2 weeks. Just before the second visit to hospital I was in a terrible state being hard able to walk or talk more than a couple of words in a sentence. It caused my heart to stop whilst I was being examined in the cardiac unit. This was an aostotic pause. I had ECGs, X-ray, blood tests, CT scan, ultrasound and an angiogram. The results were that my heart is 100% healthy but I had acute pericarditis. The problem now is that it keeps reoccurring. I have been trying to get back to cycling and regain my fitness, social life and general confidence. I wear a heart rate monitor and have the results of my Vo2 max testing so know what my heart rate zones are. I have been unable to get meaningful advice on what level of exercise will be safe for me other than take it easy and gradually increase the intensity. I did this. Thought I was ok then went out mountain biking and did an ultra steep and technical hill climb hitting zone 5.7. This bought the pericarditis back ending up with an ambulance trip to hospital after I thought I was having a heart attack. They told me that it was pericarditis. Since then I have been restricting my rides to flat rides in zone 2. Once I have been feeling ok I have pushed up to zone 3.5. This increase in heart rate seems to cause the pericarditis to re occur. When I road ride I tend to be at a far more constant heart rate which I restrict to upper zone 2. Whilst on longer road rides (only 40k) symptoms that I get are numbness in the left shoulder and arm, pins and needles in the fingers. It’s pretty scary. I rode up a moderate hill at the weekend in the heat which seems to have bought the pericarditis back. I now get dizziness and numbness in the left shoulder and arm when walking for more than a few minutes. Does anyone know what heart rate zone I should be restricting myself to and what the duration should be?

8 Replies

I too have pericarditis. I was initially treated with colchicine in 3 different occasions. I developed this after a small heart attack and 2 stents put in. I still have severe pain between the shoulder blades. It’s so debilitating. Can you advise what meds you were given and did they alleviate the pain. Thanks

in reply to AlibaliM

Hi AlibaliM. I was given colchicine and ibuprofen. I was also taking ranitidine to prevent the ibuprofen damaging the lining of the stomach. They took a long time to have any effect when I had the virus in the pericardium. Now that my symptoms are mild and the virus gone colchicine works after about a week. When I was in a lot of pain and very dibilitated They Did try me on Naproxen and omeprazole but these had side effects. Itching hands and back. This then moved to feet causing extreme itching followed by pain and slight swelling. I had to stand in cold water to stop the burning. These side effects stopped when I stopped taking naproxen and omeprazole.

Hello Snowyp, I’ve asked the same question several times to my Cardiologist and GP. I don’t think anyone will likely give you a definitive answer, as ultimately I think they just don’t know. The best I’ve had is along the lines of “do enough to improve your fitness but not too much to stress the heart.” Which makes sense but isn’t particularly helpful.

I think just trust your instincts.

From what I can make out some people will make a 100% recovery and in time be able to push themselves just as hard as they used to. Others will never quite be able to get back to that level, and it’s a sliding spectrum as to how much stress they can put on the heart without suffering problems again.

I think it’s just a case of increase little by little and back off if you’re feeling symptoms.

Ultimately I guess you’ve just got to be grateful that you can get back on a bike and settle for your body’s new limits.

in reply to MarkInMancs

Thanks markinmancs. I agree with everything that you have said. At least I’m starting to work out what the symptoms are when I am overdoing it. Do you think that I’m am causing myself long term damage with every bout of pericarditis that I get? Does the pericardium get scar tissue and contract squeezing the heart?

Ken Cooper published a table for the duration of exercise necessary to elicit a training effect for a given heart rate:

10 minutes at an average of 150 beats per minute

20 mins @ 140 bpm

45 mins @ 130 bpm

90 mins @ 120 bpm

The more you exceed this, the more you are over-training, exceeding your recovery ability and potentially impairing your immune system.

Also, don't train too frequently. The body works on a 24.2 hour circadian rhythm, and that is the minimum amount of time that must be allowed to elapse after the completion of a workout before commencing the next.

Finally, don't over-emphasise the carbohydrate in your diet. Between 1/4 and 1/3 of energy is enough. The longer you are capable of doing an exercise, the more the energy requirement can be met by natural fat (about 50% more mono than saturated, with only small amounts of EFAs, the same ideal ratio as our body fat).

I hope this helps. All the best!

in reply to Concerned

Looking at my last ride my average heart rate over a 2 hour period was 125 bpm. It went up to 135 when I went up a hill for about 10 minutes. That was when my left arm and shoulder went numb

in reply to Concerned

Thank you. I think that if I stick to 120bpm for no more than 90 minutes that will work out well. I have been doing pretty much that when I go out on very flat MTB rides with no ill effects

Hi , I'm 30 and a keen cyclist too. I've had a couple of instances of pericarditis although admittedly not as severe as your symptoms , I thought I was over it , but after going into the red on my last ride , have started to feel mild symptoms again. I guess I'm just wondering how you are getting on now , are you still having to carefully manage your training ?

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