7 weeks post surgery - couple issues

[heartlikeawheel]

Hello, my last posts were in the Introductions section - I think back in April or May - so it's been awhile.

I had the aortic valve replaced and the mitral valve repaired. The valve put in is the Medrontic Avalus at 27mm. The surgery went well and I was let out of the hospital after about a week. They kept me a little longer as I wasn't quite in sinus rhythm for a number of days but then it came around.

What I've found now is that I can't get my heart rate up with exercise. I'm not on meds. Prior to surgery I could get up to the 150s with a jog or other vigorous activity. Now I can't get out of the 115 range - despite working hard. The doc has a monitor on me for 2 weeks but not sure what that will show. Latest echo did indicate that I have a small leak at the AV. Great! So I will have another echo in a month to make sure it isn't getting worse. Blood work still shows mild anemia which I figure is common.

My questions to the veterans: Any experiences with this type of rate issue after surgery? And did it fix itself? I guess it's called Chronotropic Incompetence. If it doesn't come around I'd definitely consider meds or a pacemaker as I love jogging, tennis, biking etc. And the leak - experiences with those after replacement? Can that go away on it's own. I'm a bit frustrated that this hasn't been a perfectly seamless process but then again I know many folks have a much harder time. Otherwise I feel pretty good. My rate when asleep is in the mid to upper 50s. Which is what it was before surgery.

 

[vitdoc]

You may have what is called 2nd degree AV block. This occurs when some of the atrial signals don’t pass through the AV node to the ventricles. 3rd degree is when none pass through. Not uncommon with aortic valve surgery.
Should be visible on the electrocardiograph. Shouldn’t be too hard to diagnose. Pacer is definitely needed for 3rd degree may be needed for 2nd.

 

[Superman]

7 weeks is also fairly early for “normal”. Worth maybe calling on, but I wouldn't worry yet. “Normal” can be as long as 6 months to a year. Or much shorter. All I can say for sure is it isn’t a switch that goes off. It’s more of a, “I haven’t noticed that issue in a while. Cool!”

 

[heartlikeawheel]

Thanks guys. I do know the latest EKGs didn't show anything. Maybe I'm being impatient.

 

[egar]

Since you’ve seen your doc, this has probably already been considered, but are you on any medications that limit your heart rate. For example beta blockers do that.

I had the same problem following my MVR. I cut back on the dosage and that helped some, but even at a minimal dose, my heart rate topped out around 125. After getting off the beta blockers, my active heart rate really jumped up, even with small efforts. After months of carefully managed cardio, I was able to get back of what I would consider normal active and resting heart rates.

 

[heartlikeawheel]

So a breakthrough today at Cardiac Rehab (which I recommend) - heart rate got to 130!! And it wasn't a one off - it built to that. This was on my last exercise of the day on a Schwinn Airdyne type bike and I was pushing pretty hard - only able to say a few words at a time. The annoying thing was the recovery (rate drop) was very slow. But I still see it as a breakthrough and I didn't notice anything other than breathing pretty hard. I currently don't take meds other than baby aspirin and Sertraline (to keep my brain straight).