Help & advice please : Hello, Long... - British Heart Fou...

British Heart Foundation
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Help & advice please

Kezmaz
Kezmaz

Hello,

Long story short I have been having ‘episodes’ for almost a year now (severe dizziness, nausea, shaking of legs, jittery, breathing changes, palpitations, sweating, ectopics, left feeling weak for hours). I have had an ultrasound scan on my heart which came back normal findings, along with being given an OMRON event recorder by my cardiologist. This found Monomorphic ventricular ectopics during episodes and a frequent drop in the t waves, resulting in them requesting an exercise stress test to be done along with cardiac Ischemia being mentioned.

I completed the exercise test 2 weeks ago now and have been in a bit of a flap ever since waiting for the results.. I only managed to get up to the start of stage 4 of 9, felt like I was going to faint and ended up having pretty much a panic attack on the machine and couldn’t breathe.. I haven’t had a panic attack in years and was only ever one time!

Is this an effect that cardiac Ischemia may have caused this to happen during exercise? I’m not the fittest but I am 28 and have heard of 70 year olds completing it.. they did say I still managed to get my heart rate up to 90% of what they wanted (178 if I remember rightly) so that it was ok that I had to stop.. but now I’m left feeling concerned that they will assume it’s stress based when it most certainly isn’t...

TIA x any advice is greatly appreciated x

9 Replies
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Ah sorry you feeling anxious about this all Kezmaz. And you are still young, my goodness. I will keep you in my prayers young man. Cardiac Ischaemia I am unfamiliar with that, but I had a heart attack February this year. You need to follow a community on here which is familiar with that. 🙂

Kezmaz
Kezmaz in reply to Snowdrops_17

Thank you, I appreciate that 🙂

I do hope you are on the mend after you heart attack.

Have you had your thyroid tested ?

Kezmaz
Kezmaz in reply to bantam12

Hi bantam,

I have had everything obvious checked bloods wise, only thing that came up was low prolactin levels.

Kezmaz
Kezmaz in reply to bantam12

And more recently found that my kidney function (creatinine level) was raised but not of any major concern

Hi Kezmaz,

First of all lets get some plain language on the table:

Cardiac ischaemia simply means not enough blood flow (and, therefore, not enough oxygen) to your heart for how hard it's working.

The heart rate they were looking for is an approximation of the highest speed they expect your heart to be able to achieve based on your age (your MHR - maximum heart rate).

There are a few different formulae they can use to estimate it but all of them are ONLY an approximation. To give you an example of that, according to age my MHR should be between about 168 and 172 beats / minute but I can reach 181 if I really REALLY push. That's not a good thing, or a bad thing, it's just an individual number because we're all a little different.

What they look for in a stress test is whether you're able to reach 85% of the calculated maximum. So, in my case, they'd stop the test at around 143 beats per minute, in yours they would have been looking for 151.

At 85% MHR you physically can't take in as much oxygen as your muscles (including your heart) need. That's known as anaerobic ("without air") exercise and is something you simply can't keep up indefinitely. No-one can. If you try to then you become properly physically exhausted - not just "a little bit tired" but "can't keep the pace without falling over" tired.

The fact that you got to that point and beyond without suffering chest pain or having anything bad show up on the ECG machine (they would have stopped the test earlier if there had been!) means that your heart is getting at least enough blood - and oxygen - to work at that rate. Which is good.

Hitting 90% is actually getting into the "maximal" zone which even trained athletes only go into for a couple of minutes or so at a time. Staying at that level for any length of time WILL leave you throwing up and falling over!

So, you reached a very high heart rate without suffering chest pains or ECG changes, which is good.

You also, at level 4, were working at about 10 METS. That means your body was burning energy around 10 times faster than it does when it's resting, which is not a bad level for someone who self-describes as "not the fittest". That would improve if your fitness improved because you might reach that level at (say) 75% of your MHR and have another 15% to play with on higher levels.

In short: There's obviously an issue from your original symptoms and the 24 hour monitor but the fact that you got to that heart rate without them pulling the plug is a very good sign.

Try not to worry while you wait for the results and, assuming all is ok, perhaps ask your GP about any exercise referrals that might be available to raise your overall fitness in order to keep it that way :)

Wow, thank you so much for taking the time to give me such a lengthy, detailed reply. That has actually very much put my mind at ease about the test, and although I hope they don’t find anything I feel I want them to find something at least so they can find a fix and I can start to actually feel normal again.

Thanks again.

As previously stated the fact that you can exercise to 90% of your max heart rate without ECG changes or a drop in blood pressure are reassuring and not suggestive of coronary heart disease especially given your young age. Stopping at level 4 just means that you are not very fit.

You got some excellent info Kezmaz. From this super group of people. Hope it re assures you. Have a good day. Try not to worry. And i hope all goes well. Ask questions at your next appointment. So you understand. And not worry yourself silly. Take Care

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