Puzzling symptoms while exercising beyond 20 minutes!

[guillemot1980]

Hi everyone, I am a 42 year old man, always very slim and active, non-smoker, hoping to get your opinions about some puzzling symptoms I have been experiencing while doing moderate exercise (jogging fairly leisurely on treadmill).

These manifest as a kind of unsteady, mildly dizzy "need-to-stop" kind of feeling which always seem to come on about 20 minutes into exercise. There is no real sense of fatigue or breathlessness. My hypothesis is that this is due to some kind of gradual increase in blood pressure, but I'm not sure.

I have taken some readings before/after exercise. I usually begin at about 125/80, and then end at 150/90. I did wonder whether the diastolic should be increasing this much?

My medical history is quite complicated! but to be as concise as possible and to rule out the obvious:

I have type 1 diabetes (since 1988): I check my blood sugar regularly and the symptoms are not due to low blood sugar.

I had a single vessel heart bypass 2 years ago – this was successful and latest CTCA scan performed June 22 showing all is well. Exercise stress test completed last year and everything looks good too. (One thing to note is that I had these types of symptoms pre-bypass too)

I have had hypertension for 25 years: it is controlled well with bisoprolol, perindopril and indapamide. I have always maintained that I can feel my high blood pressure, but doctors have disagreed. My cardiologist has suggested the symptoms are due to impaired exercise response with bisoprolol – however my heart rate increases steadily over the duration of the exercise session and, as mentioned, there is no sense of breathlessness or real fatigue.

... so I am otherwise fit and well. It's just really frustrating that I can't seem to exercise past the 20 minute mark without feeling really awful!

Thank you for reading and for your time. I look forward to hearing from you.

[guillemot1980]

Hi Hidden – thank you very much for your kind reply.

I'm only on 2.5mg bisoprolol, which I understand is a low dose. Strangely enough these symptoms also occurred pre-bypass when I wasn't taking the bisoprolol.

At 20 minutes my heart rate reaches about 140. If I manage to get to 30 minutes then it's usually at about 150. On my heart rate app I can see it rising steadily over time. My jogging pace remains constant at 7.5km p/h – so not very fast.

[guillemot1980]

Thank you Hidden – a couple of things for me to try there. Yes, I imagine that 7km p/h is going to be almost fast walking pace, but let's see what happens. Thanks again!

[Hidden]

I suggest you discuss this with the BHF Heart Helpline nurse or better your GP, who will be able to offer a professional opinion.

bhf.org.uk/informationsuppo...