I have posted this information many times on the site. I find it extremely valuable.
I hope this will help you explain to your doctors how to handle this in the future.
Below is the information..
Topic: Heart Disease: Laurie Anderson, RN, BSN >> Discussion: Exercise with
low pulse from medication (by Arlyp (WebMD))
Re: Exercise with low pulse from medication
by ljandie91 (WebMD), 8/18/00 10:09 PM
Your heart is getting an adequate workout as long as you raise it 20-30 beats
per minute over your resting levels. You can't calculate a target heart rate
based on the traditional method of subtacting your age from 220 and
multiplying it by 70-85%, because of the beta-blocker.
In the cardiac rehab setting we usually use 70-85% of the highest heart rate
achieved on the pre-exercise stress test, if the medication(s), especially
beta-blockers, were taken before the test. If the medication(s) were held,
the highest heart rate achieved must be further adjusted for these meds;
typically a range of 10-20% more depending on the size and frequency of the
beta-blocker dose and the dose(s) of other medications being taken that may
also be lowering the heart rate. Sometimes this method of calculation is
ineffective; in this case we often use the simple formula of resting heart
rate plus 20 to 30 beats per minute. This range is decided upon based on
whether or not the person is still ischemic (blockages that are preventing
adequate blood flow to the heart), the amount of heart muscle damage from the
heart attack, the ejection fraction and other individual considerations.
In regard to your question about time of day to exercise, in my opinion you
are actually better off to exercise earlier in the day, when your
beta-blocker is having the most efffect on your heart rate. I can't evaluate
this in relation to your condition, because I don't know what the situation
is with your heart's blood flow. In general the effect of the beta-blocker is
to improve blood flow to the heart muscle, so it is better protected from the
potential effects of decreased blood flow and thus you are less likely to
have angina. Hope this is clear and helpful; I will watch for additional
posts from you should you have another question.
Sincerly, Laurie Anderson, RN, BSN
3/23/00 Ascending Aortic Dissection-St. Judes mech valve+graft, Vanderbilt, Nashville, TN
9/16/10 ON-X Aortic Valve/Root Replacment, Cleveland Clinic,OH, Dr Pettersson
9/16/10 Aortic Stent and Frozen Elephant Trunk Procedure, Cleveland Clinic,OH, Dr. Roselli