aortic stenosis and heart beats per minute.

[d333gs]

I was wondering if there was any correlation between maximum BPM and the degree of stenosis? Does stenosis restrict BPM? The logic being, during exercise, a large valve opening would allow more BPM than a restrictive valve would.
Does anyone know?
Thanks.
John
PS
I have been in the waiting room for a few years. I have been on the 6month ecogram check up schedule.. for the first few years I was told I had a torn aortic valve which is not closing properly. Last year my number hit 48 and I was sent to another cardiologist who thinks I have a bicuspid aortic valve but would not confirm it. I am asymptomatic. Stress test was good.

 

[cldlhd]

Sorry I misread your original post. So I edited mine. I mean all else being equal regarding your physical condition if the opening became more restricted I would think the heart would have to work harder and beat faster to keep the same level of activity.

 

[Superman]

I know it has to beat harder. Don’t know if that necessarily means faster. My pediatric cardiologist always explained it like any other muscle. The harder it works, the bigger the cardiac muscle gets. And mine was getting a lot bigger (thicker cardiac walls) when it was time for surgery at 17. After my surgery at checkups, he’d always say my heart was on vacation.

I had stenosis and regurgitation. To the child I was, he just said the valve didn’t open all the way (stenosis) and didn’t close all the way (regurgitation). So my heart had to work really hard.

In terms of your question, I’m not sure that BPM is affected that way. Your muscles demand oxygen. Your heart provides them oxygen by pumping blood to them. To push the same volume through, it just has to squeeze that much harder. But I don’t know if it would lead to greater or less frequency.

 

[pellicle]

The logic being, during exercise, a large valve opening would allow more BPM than a restrictive valve would.

I don't think it works like that.
The larger opening allows a higher flow of blood (small pipe / large pipe) and since the vascular system isn't designed to take the pressures of a "common rail diesel" the smaller hole essentially restricts flow; giving the body no choice but to beat faster in an attempt to shove blood around.

First and foremost the blood carries oxygen, you die without that in less time than say nutrients. So if the Oxygen demand is there (from exersize) but you have a restricted flow due to the valve then it has to pass smaller loads more often.

This is why resting rate goes up; you're not doing anything but still the heart has to beat faster to make sure you don't die.

The next problem is that if you've ever squeezed water out of a plastic bag you'll note how much harder it is to squeeze a liter of water out of it with a tiny hole. So the muscles expand (which is a bad thing).

So the reduced opening results in a higher pressure inside the heart for a meagre one outside the valve (in the Aorta)
HTH

 

[pellicle]

I was wondering if there was any correlation between maximum BPM and the degree of stenosis?

max bpm is determined by your hearts fitness and your cardiac arteries supplying blood ... its a factor of age too, with most HRmax calculations factoring in age

Here is a good starter (googling will reveal that in the fitness world there are many variations on this calculation):

You can estimate your maximum heart rate based on your age. To estimate your maximum age-related heart rate, subtract your age from 220. For example, for a 50-year-old person, the estimated maximum age-related heart rate would be calculated as 220 – 50 years = 170 beats per minute (bpm).​

 

[d333gs]

Thanks everyone

max bpm is determined by your hearts fitness and your cardiac arteries supplying blood ... its a factor of age too, with most HRmax calculations factoring in age

Here is a good starter (googling will reveal that in the fitness world there are many variations on this calculation):

You can estimate your maximum heart rate based on your age. To estimate your maximum age-related heart rate, subtract your age from 220. For example, for a 50-year-old person, the estimated maximum age-related heart rate would be calculated as 220 – 50 years = 170 beats per minute (bpm).​

Hi Pellicle " This is why resting rate goes up" Ok , this is interesting With stenosis our resting BPM go up?. Do you have any links to info about this? I had been searching for that but could not find anything on it . My logic was: When the heart fills with blood it is harder for it to pump it out if the valve is small but would it take longer too? So a 50 year old with stenosis may not be able to get up to 170 BPM because it takes too much time to eject the blood through the obstructed valve........ ? Maybe thats a situation when you faint?
Thanks
John

 

[pellicle]

" This is why resting rate goes up" Ok , this is interesting With stenosis our resting BPM go up? Do you have any links to info about this?

no, its simply my observation

. I had been searching for that but could not find anything on it .

probably because its not common that people into "fitness" have AS

My logic was: When the heart fills with blood it is harder for it to pump it out if the valve is small but would it take longer too?

the body is a homeostatic mechanism, it strives to keep things the way it wants. When its impaired then it will strive harder ... if the pressures are so high that its taking longer then I'm suspicious that real bad things are happening there.

This is really the domain of the Cadiologist if you want more specific answers.

however I would view that its very much a timing thing (and consider ejection fraction measurements in this context). So it has an amount of time to squeeze and if it doesn't get it all out ... welllll that's bad

So a 50 year old with stenosis may not be able to get up to 170 BPM because it takes too much time to eject the blood through the obstructed valve........ ?

I would sincerely doubt you'll get to 170 ... just because that's the theoretical max from a generalised simplistic calculation aimed at healthy people doesn't mean you will obtain that.

Maybe thats a situation when you faint?

or worse.

 

[cldlhd]

I don't think it works like that.
The larger opening allows a higher flow of blood (small pipe / large pipe) and since the vascular system isn't designed to take the pressures of a "common rail diesel" the smaller hole essentially restricts flow; giving the body no choice but to beat faster in an attempt to shove blood around.

First and foremost the blood carries oxygen, you die without that in less time than say nutrients. So if the Oxygen demand is there (from exersize) but you have a restricted flow due to the valve then it has to pass smaller loads more often.

This is why resting rate goes up; you're not doing anything but still the heart has to beat faster to make sure you don't die.

The next problem is that if you've ever squeezed water out of a plastic bag you'll note how much harder it is to squeeze a liter of water out of it with a tiny hole. So the muscles expand (which is a bad thing).

So the reduced opening results in a higher pressure inside the heart for a meagre one outside the valve (in the Aorta)
HTH

I understand the theory that if your heart has to work harder to accomplish the same task the muscle is going to grow which is generally looked at as a bad sign but what about if somebody is really fit and they work out a lot, not saying I fall into that category but, would their heart also be a little larger because it is working out more like any other muscle? I realize that in this scenario the resting heart rate would be lower though.

 

[Superman]

I understand the theory that if your heart has to work harder to accomplish the same task the muscle is going to grow which is generally looked at as a bad sign but what about if somebody is really fit and they work out a lot, not saying I fall into that category but, would their heart also be a little larger because it is working out more like any other muscle? I realize that in this scenario the resting heart rate would be lower though.

The body is an amazing thing. Just because a person with stenosis can do something a “normal” person can do, doesn’t mean their heart isn’t compensating in some way to make this happen. So yes, they can be really fit and work out a lot and keep up with other folks. But their heart is working a lot harder to make this happen. While your quads or biceps getting bigger isn’t a bad thing, growing your cardiac muscle to compensate is generally frowned upon. The heart is just going to do what is has to do to meet the demands of the body, right up until it can’t anymore.

Pellicle’s analogy is right on. It’s not growing because it’s beating too fast. It’s growing because it has to get the amount of blood the body needs out of a smaller hole. It has to squeeze harder.

 

[d333gs]

no, its simply my observation



probably because its not common that people into "fitness" have AS



the body is a homeostatic mechanism, it strives to keep things the way it wants. When its impaired then it will strive harder ... if the pressures are so high that its taking longer then I'm suspicious that real bad things are happening there.

This is really the domain of the Cadiologist if you want more specific answers.

however I would view that its very much a timing thing (and consider ejection fraction measurements in this context). So it has an amount of time to squeeze and if it doesn't get it all out ... welllll that's bad



I would sincerely doubt you'll get to 170 ... just because that's the theoretical max from a generalised simplistic calculation aimed at healthy people doesn't mean you will obtain that.



or worse.

Re 170, You will get up there for short periods, I am 67 and I get there

 

[dornole]

Interesting, my heart rate has always spiked much higher than the standard formulas with exercise (primary issue is mitral stenosis). This is even when resting heart rate is 60. If I am in a supposed “training zone” I am not even walking fast and breathing normally. If I run it goes over the supposed 100% max and stays there even if the perceived exertion is moderate. This is true anywhere in the fitness range I experienced so far (walker to 5k runner).

 

[d333gs]

Hi dornole , any idea what the cause was/is?

 

[dornole]

I always figured it was just me, those targets are just guides. But now I’m wondering if it’s stenosis related and how my body has adapted.

 

[newarrior]

Pellicle can you explain, ". I had been searching for that but could not find anything on it .
probably because its not common that people into "fitness" have AS"...

 

[d333gs]

Well.... Fitness and AS , As I mentioned above my first diagnosis by way of ecogram was that I had a torn or deformed AV. Then I was sent to one of the top guys in Marseille (I am in France) and he is pretty sure it is a bicuspid valve but not positive. No enlarged left ventricle, yet.The stress test was fine. I wanted to keep track of things so I got a Apple watch that does a good job of tracking and documenting your heart activity. I gave up tennis, which I played 2hr a day and started a walk/ jog routine. The plan was to get a routine going and monitor my performance, try to get to my max and watch for a performance decline as a way of planning my surgery. The first year I was doing 8K cross country in 1hr20 with a BPM peak of 185. I am now doing 13K in 1hr 50 min . Same terrain but longer befor I turn back. Max BPM today was 128 Resting BPM was 52. So this is why I am interested in the relationship of AS to BPM. I have another Echo in 5 months