Curious, Minor Symptom Check

[nate_c]

Hi, All.

Just wanted to check in and see if anyone else out there has experienced something similar to what I've been feeling lately. I don't think this is anything major--but a little, well, strange.

Some background first: Before my AVR, I was lucky enough to be almost completely asymptomatic, but the one odd symptom I did experience was a total inability to sleep on my left side. If I tried, I would become very aware of my heart beat (I could feel and hear it prominently, to the point where it would keep me awake), and my regurgitation worsened, I started to get a dull ache in my chest when lying on my left side. No such problems on my back or right side.

Fast forward to now. After AVR, I can sleep on my left side again, although I'm still a little more aware of heartbeat on that side. No dull ache anymore either. However, after my long runs, for about a day or so, I can feel my heart beating in a way that feels very similar to what I used to experience sleeping on my left side. That is, I notice my heart beats much more, and I have a very mild ache inside my chest, although I hesitate to use the word "ache" at all because the feeling is very subtle. I have this feeling only after longer runs (which for me right now, is 11-14 miles). Never happens with shorter runs or cross-training.

I'll be the first to admit that maybe I just feel this because I'm overly sensitive to all thing cardiac now. Anybody experience anything similar? Am I just a little bonkers? Thanks in advance for any responses/insights.

 

[Eva]

In my humble opinion, I would avoid the longer runs that cause these symptoms and would stay at the pace that does not cause you any symptoms and increase the distance a LITTLE BIT at a time.

I only sleep on my left side and I find it helpful to rest my right arm on a big pillow which will take some pressure of bending over my chest completely.

Good luck.

 

[Guest]

However, after my long runs, for about a day or so, I can feel my heart beating in a way that feels very similar to what I used to experience sleeping on my left side. That is, I notice my heart beats much more, and I have a very mild ache inside my chest, although I hesitate to use the word "ache" at all because the feeling is very subtle. I have this feeling only after longer runs (which for me right now, is 11-14 miles). Never happens with shorter runs or cross-training.

I'll be the first to admit that maybe I just feel this because I'm overly sensitive to all thing cardiac now. Anybody experience anything similar? Am I just a little bonkers? Thanks in advance for any responses/insights.

Before my AVR, when I was running or after a lot of physical exertion (yard work/other types of activity) my heart always took a while to settle down afterwards, to resting heart rate. I would occasionally get chest pain with exertion. The next day it would be ok, no issues. Now after AVR, I sometimes have the same issue with heart rate but I don't get chest pains. I attributed the chest pain to my bicuspid valve with regurgitation. I had PVCs prior to surgery, I have PVCs and PACs after my surgery, the PACs I attribute to the surgery.

Did you have any rhythm issues prior to surgery and maybe that's what's going on after AVR? Did you take a beta blocker prior to surgery or are you taking one after AVR? I do not take a beta blocker as the rhythm issues are not that bothersome for me so far. When I am at rest (relaxing or going to sleep at night) I notice them more.

 

[nate_c]

Thanks for the thoughts. I hadn't considered rhythm issues. I did struggle with rhythm issues after surgery (both afib and PVCs) for about 3 months, and then they just stopped like someone had flipped a switch. This feels very different to me, and far more subtle. Also, I should have mentioned: I had my AVR in August of 2010. I have a tissue valve. No warfarin or beta-blockers.

 

[Lily]

Is it possible your minerals are somewhat depleted after your long runs? Or maybe you're suffering from some dehydration afterward? Both of those things can trigger my arrhythmias.

 

[Philip B]

Sensitive?

Sensitive?

Keep in mind that you're roughly only around six months post-op. As you engage in workouts like running, you're probably still doing some remodeling work on your heart.

Even though I'm approaching the four year anniversary of my AVR surgery this spring, I still notice differences in my heartbeat when I engage in heavier workouts.

-Philip

 

[ALCapshaw2]

Do you have a Stethoscope?

If so, LISTEN to your heart when you are experiencing these symptoms to see if there is an irregular or rapid heartbeat.

Exercise induced arrhythmias are a known possibility.

It wouldn't hurt to mention this issue to your Cardiologist.
He may want to put you on a 24 hour Holter Monitor to see what is going on.

'AL Capshaw'

 

[SumoRunner]

Re. rhythm issues : Avoid caffeine.

 

[nate_c]

Thanks for the insights and suggestions. Just a quick-follow up. The advice to check in with my doc seemed sound. I checked in and have a go-ahead. As long as my HR recovers well after exercise and doesn't become erratic (more afib or PVCs) he thinks I'm OK. He noted that some people are just much more aware of their heart beat than others for whatever reason, while others never feel it. I'll accept that, since I feel pretty good and seem to still be improving every week.

Jack: I'd heard that about caffeine, and alcohol too, but I don't drink too much of either. Interestingly, though, I do often use a couple of the energy gels with caffeine during my long runs... Hadn't really thought about it before. Maybe I should switch to the non-caffeinated kind.

Al: I would have never thought to buy a stethoscope and listen for rhythm irregularities. Given my recent history with these issues, probably wouldn't hurt. My kids would get a kick out of helping with that task. I appreciate the suggestion.

Eva: I totally agree with building back slowly. I was running much longer distances in the months immediately before my AVR (was in the middle of a marathon push and feeling great when a routine echo showed that my valve had suddenly deteriorated after years of no change). I've tried to add only about 1 mile or less to my long runs each week as I recovered and improved, and I've held steady at around 13-14 mile long runs for a couple weeks now and focused on cross-training to try to get some upper body strength back too. Those first push-ups and pull-ups were an adventure. I felt like I'd gained 100 pounds .

Philip and Lily: Excellent points. I think I'm staying hydrated on these runs, and I've often wondered what the actual physiology of heart remodeling is, and how the changes affect performance... It's a strange thing to me that such a crucial part of the system can change form so dramatically. When I had rheumatic fever as a kid, they told me my heart enlarged to nearly twice it's normal size by the time I was finally diagnosed. By the end, I couldn't even walk down a long hall without stopping to rest and catch my breath.

Thanks again for the replies. It's great to be able to chat with good people who know what it's like...