NSTEMI and BP / Heart Rate

[doktordru]

Hoping for some enlightenment here to satisfy my own curiosity.

Had an NSTEMI July 2022- and all is good now - no other intervention beyond yr1 meds - now just Bisoprolol, Atorvastin and Disc Aspirin.

Moderate lifestyle changes have seen weight fall from 94.6 on discharge to 77.6 this morning - consistent BMI around 21.5.

Acquisition of a Smart Watch has been a great reassurance in terms of monitoring my heart rate - my question, born out of curiosity is had I been wearing the smart watch (Apple in my case) when experiencing my episode last year what would it typically have shown around Heart Rate.

Ordinarily my resting HR is now mid/high 40's - 50's/60's when walking and higher when exercising running etc....

But continually wonder what happens to HR when NSTEMI type incident is happening?

Any insight welcome . Stay warm and well everyone.

A

[Lowerfield_no_more]

If it's my help, nearly six years ago I had some unusual chest discomfort but no other symptoms including no quickening of heart rate, thought it was the onset of a chest infection, and having been advised to attend A&E was then told I had had an NSTEMI which resulted in four night in hospital and an angiogram, and so here I am today. Anyway it's good you have reduced your body weight which will undoubtedly help your heart and will also bring other benefits too. I also decided to lose a lot of weight last year and certainly feel better for it. As for the heart rate my heart rate at rest is lower 50s and can drop to lower 40s at night when asleep, which is similar to you. But tbh although I did wear a smart watch after my HA I gradually lost interest in it and don't bother now. It is what is it is. I know and understand my exercise limits and work within them.

[DWizza]

I had Nstemi this July and quadruple bypass. My resting HR prior was 45-55 (garmin vivoactive 4s) , I was fit , age 62?weight training , yoga , manual work round our small holding , walking and a lifetime of sports . Post procedure I attended phase 3 NHS cardiac rehab which I found to be underwhelming, far to easy. I am now with a cardiac specialist coach who has designed a program for me to achieve 5 & 10km and a return to weight lifting. My heart rate is back to resting in the 45-50 range and BP low end normal 110 and below over 70-80. I’m on Bisoprolol 2.5mg, artovastatin, pantaprazole, clopidogrel, aspirin.

I will be going to GP in a week to discuss tweaking my Bisoprolol or changing to 1.25 Rampiril as per consultants advice.

My nstemi presented as trapped wind , pain directly in my sternum. Ambulance crew hooked me up to ECG and said my heart was fine , whatever had happened had passed. If it wasn’t for them insisting I go into hospital for blood tests I wouldn’t have known I’d had a heart attack!

[Qualipop]

NSTEMI and two stents 5 years ago. Heart rate was normal but there was just a blip on the ECG that made the paramedics suspect HA. Only symptoms were horrific indigestion for 3 days they on day 3, tingling pain down left arm and up neck. I was eating antacids like smarties. It was only when the tingling started that I got suspicious and rang for help.

[Smitty1956]

Hi, doktordru,

I was wearing my Apple Watch when I had a NSTEMI HA in March 2022. I had been lying on my couch watching some television after a “normal day.” I think that I felt a little unwell, and I checked my heart rate. The watch showed that my HR was much higher than normal, but that the rate continued to increase. That set off my anxiety and panic so I called an ambulance/EMT squad.

My heart rate continued to climb and my BP was through the roof. These scary numbers and my anxiety caused me to go to the hospital emergency room where it was confirmed that I was having a HA.

To me, I feel that the Apple Watch helped to save my life. However, I don’t know if everyone experiences a NSTEMI HA in the same way and same symptoms showing up on the watch.

I will add that the heart rate showing on the watch matched exactly with the heart rate showing on the hospital monitor. Both heart rate and BP got so high that I could not look at the numbers—made my anxiety and situation worse.

[doktordru in reply to Smitty1956]

Thanks Smitty 56

- that's interesting to note. My own circumstances, and I was without an Apple Watch at this stage, were that I woke up one morning feeling bad, flue type symptoms and muscle aches across forearms, neck jaw etc - but no pain in torso or heart. I muddled through the day - different pain relief doing not much to aid me, had an awful night with almost no sleep and after a call with my GP the following morning found myself at A&E asking for a Traponin test. Oodles of other tests including x rays and ECG plus blood were done before the Traponin. ECG was 'ok - albeit with a slight query' - it was only the Traponin that saw me fast tracked to the ward for more meds, monitoring and investigations. As I never once felt any heart issues - I've always wondered what my heart was doing at the time and how it would have been reported via heart rate monitoring on the watch - hence the orig question. I don't recall what my readings were when I first went into hospital - but noting that I took a bunch of pills straight away on hotting the bed, they must have had an immediate impact. FFWD 18 months and I'm doing great (I think) and do find the watch reassuring when running and exercising.

[Smitty1956]

Perhaps the pain relief (especially if that included aspirin) actually helped you during the HA. My doctor and cardiologists suspect that a piece of plaque likely broke off and formed a clot, which caused my HA. It seemed to all come on suddenly with no warning.

I had been out working in my yard that day—trimming some shrubs and cleaning vines and weeds off of my fence. I had emptied my trash and pushed the can to the curb, washed dishes, made dinner—just normal stuff all day. I had not noticed any pain.

During the HA, I did not notice any heart pain. I did feel hot and tired, and, eventually a little sweating. I will be honest and tell you that I did not take my normal medication that day, which included a BP med. That was completely wrong to forget/ignore.

18 months later, I now use my watch for many things. I track my sleep hours, my heart rate and breathing rate while sleeping, and last night, I used a mindfulness and a breathing app before going to sleep. I also use the watch to track my walking exercise and I can check my heart rate while working in my yard. Just a few of the things that I track. But I still credit my watch for alerting me to my heart attack in March 2022. It scared me to death at the time, but it also prompted me to seek medical help.

I’m really glad that you are doing so well now! That is really good, and I wish you all the best going forward! ❤️

[doktordru]

Thanks Smitty - I've often reflected on the meds I took on the day - which I think were a mix of paracetamol and ibuprofen over the course of 24 hours - I literally took whatever was to hand and in retrospect underestimated the humble aspirin. Won't ever make that mistake again! Stay well!