Extreme exercise

[rr3972]

My cardio doctor recommended that I don’t let my heart rate go above 150 bpm and not do do things like pull ups. I have a tissue valve in the aortic position and everything is good. I’m really missing pushing my exercise to the maximum, it’s fun for me. I used to ride my bicycle for hours at 150 and when I hit a steep hill I could keep it at 180 for 30 minutes maxing out at 192. IS MY CARDIO DOC OVER CAUTIOUS?

 

[pellicle]

as far as I understand things (hopefully others can provide more) with a tissue prosthetic if you were able to do it before you should be able to get back to that again with training.

It was explained to me that the issue is pressurization of the blood system, which comes from squeezing all the blood, such as in the quads when straining a heavy squat combined with holding your breath pressurized (which squeezes the blood in the lungs too) rather than simply high HR from aerobic activity like spinning.

I must say that's a high number and unless you're under 40 (I'm guessing your about 47 or 48 now) I'm sort of surprised you can sit on 180 for so long, standard formula (220 - age) or some of the more finely tuned alternatives would put a max HR a bit under that number. I would wonder (not knowing) if that's not possibly doing you some harm.

I'd probably want to consult with an exersize physiologist. Dunno maybe @leadville may have some better feel for such things, myself back in my late 30's I knew that if I did more than 154 up an extended climb I could do it, but if it started raising to 160 I knew I'd burn out before I got to the top, and that was nothing like a 30 minute climb. I would not regard myself as athlete, just fit for my age (then).

 

[R1Phrankey]

Do any guidelines exist on this? I have a mechanical aortic valve and am also riding my bike frequently (11.000 miles last year).
Several times a week I am riding my bike in my anaerobic zone (i.e. high hearth rate and blood pressure) and I am sometimes thinking on the possible negative effects of this. May it influece the valve? Do I need to be worried and keep my hearth rate in a lower zone?

 

[dwhist]

I bike about 3000 miles a year and my cardiologist who also rides told me to keep my heart rate below 150. I recently did a ride that was a long slow up hill and for an hour my heart rate was between 125 and 130. I am not a fast rider. I was able to show him the heart rate chart from my Garmin. He was very happy and said that showed my heart was working well and did not order a stress test this year.

 

[nobog]

Do any guidelines exist on this? I have a mechanical aortic valve and am also riding my bike frequently (11.000 miles last year).
Several times a week I am riding my bike in my anaerobic zone (i.e. high hearth rate and blood pressure) and I am sometimes thinking on the possible negative effects of this. May it influece the valve? Do I need to be worried and keep my hearth rate in a lower zone?

Don't worry about the valve - when the valves are under development they are cycled in an accelerated life tester at 1000 beats per minute so 150-200 is nothing, the valves are typically tested up to 500 mmHg with no structural detriment.

 

[R1Phrankey]

Thank you for this information. Good to know how they test these valves! That give me some good feeling about my rides.

 

[Agian]

Don't worry about the valve - when the valves are under development they are cycled in an accelerated life tester at 1000 beats per minute so 150-200 is nothing, the valves are typically tested up to 500 mmHg with no structural detriment.

Wow

 

[spartangator]

This question comes up a lot because it seems like people get quite different advice so you're not alone in the wondering. While our cardiologists know best by their training and familiarity with our cases, it does seem hard to get evidence-based advice from care teams, as opposed to very conservation rules of thumb. I'm just writing all this to say you're not alone in your wondering.

For me, I just try to stick to being smart about things in the sense of not holding my breath when lifting and backing off when my heart-rate monitor points out things are getting too high. I recover a bit and get back to it, basically. I'm 100% not suggesting this for anyone else, just pointing how I've chosen to manage things the last dozen years

 

[tom in MO]

The only exercise I was told to avoid were those that require you to hold your breath, like some isometrics. I was told there was no need to monitor my heart rate once I finished cardio rehab.

 

[SumoRunner]

You should join this group. We've written two books and have many amazing stories of return to sports of all kinds including high level competition.
https://cardiacathletes.com/

 

[epstns]

I have about the same advice from my cardio -- "If it feels good, do it. If not, don't." Of course, he smirks at me when he says this, knowing that I am still taking 25 mg/day of metoprolol, and no matter how hard I try, I can't get my peak heart rate above about 145 BPM. Until my early 60's, I was running/jogging daily, often maintaining a max heart rate of over 160 BPM. I had no issues with rate then. After surgery, I had a tendency toward tachycardia and afib, hence the beta blocker. I also have a pacemaker, but it has no impact on max heart rate, as I rely on it only for ventricular pacing. My atrial pacing is all natural about 95% of the time.

It is probably a good thing that my cardio and my electrophysiologist both told me not to worry about the actual number of my max heart rate, because I have yet to find a monitor that will dependably read my rate.

 

[pekster11]

during this lock down period i've been doing alot in my home gym

i've been running 10km on the treadmill most days

keeping the speed at a moderate 14 km/hr to stop myself exerting too much

heart rate gets up to around 140bpm...resting heart rate drops as low as 48bpm sometimes

 

[slowcpa]

anecdotal reply here. i had a bav replaced with a stintless porcine in 2008. i bike. a lot. with people who are mean. i also see heart rates of 190+ (although only for a few minutes). last year, all of a sudden, my valve started wheezing so loud my wife could hear it in the car. i was light headed one night so i went to the ER and after some echos cat scans, etc. the docs said i might have developed a leak and i should keep any eye on it... a few weeks later my cardio told me he thought i may have pulled a suture on the valve as a result of my aggressive attacking of hills. a few months ago i got dizzy again. this time the er cardios told me they thought i had a clot on the surface of the valve. heparin drip for 5 days . then self administered stomach shots for a week, then coumadin for a month. no change to the valve. so after a second tee they all decided i had torn the valve. two weeks later i get a tavr. two weeks after im cleared for biking and slowly working back up. ps. tavr is not "like a colonoscopy" which is how it was sold to me (my ef went from 60 to 21 but thats another story)

 

[pellicle]

weeks later i get a tavr. two weeks after im cleared for biking and slowly working back up. ps. tavr is not "like a colonoscopy" which is how

Wow, glad you're still with us
Did they give you any life expectancy of the TAVR?

 

[bizinsider]

. two weeks later i get a tavr. two weeks after im cleared for biking and slowly working back up. ps. tavr is not "like a colonoscopy" which is how it was sold to me (my ef went from 60 to 21 but thats another story)

OK, I'll bite - I'm interested in that "another story."

 

[jcgtok17]

epstns, I am only comfortable running with a heart rate monitor, well over 200km in April. I bought wahoo which is a chest strap and phone app. Works great and syncs with my Suunto 5 smartwatch (which does read HR, but less accurately from wrist).

 

[Protimenow]

My hospital gave me a pulse oximeter last week. I use it to ger a nearly instant view of my currene heart rate. I don't care much about the oxygenation level. This has been useful to me -- yesterday, when my SVT became severe, I had the informatin I needed - and correct pulse numbers - to check with the doctor. Without it, I may have tried to get updated results from my FitBit or a phone app. Having an immediate figure sure helps...

 

[pekster11]

just a query about pulse oximeters (i've recently purchased one):

my blood oxygen sat level is usually 97-98%

would having severe aortic stenosis affect blood oxygen levels ?

My younger brother using the same oximeter gets 99% (admittedly he is a 23yr old professional soccer player, so would expect to score v highly on that)

 

[Protimenow]

I don't know if aortic stenosis would have much of an effect on your oxygenation levels. The blood is passed through the lungs, where CO2 is removed and exchanged with O2. I don't know that this transfer would be affected by a poor flow of blood into the lungs. The issue is probably how efficiently the blood is exchanged in the lungs, then sent out through the arteries to the rest of the body. Pulse Ox may be relatively unaffected by this - but I'm no expert.

FWIW - I'm having severe arrhythmias. Last week, I saw my electrophysiologist, complaining about shortness of breath and overall fatigue. The EKG showed Pre-ventricular contraction, which probably gave me these symptoms - but my Oxygen level was 99% - the tech who tested the oxygen level commented that she rarely sees 99%. This was EVEN though my heart wasn't working as it should.

So - in a few words - I doubt that your issue would affect your oxygen levels. If your oxygen levels fall to 90 or below (from what I've been told), there may be a problem.

 

[ATHENS1964]

I would to buy a accurate oximeter as nonin but that is very expensive the other I do not trust see the link

https://pubmed.ncbi.nlm.nih.gov/27089002/