Heart rate setback - opinions needed

[jax3172]

I was rehabbing nicely from AVR and aorta repair until about 12 days ago. Then, my heart rate started to creep up and I seemed less able to tolerate exercise, and I seem to have lost quite a bit of energy. My cardio wants to wait until next week to see how I feel. Three weeks ago, my resting rate was about 60 - 65. Now, my resting varies from 80 to 100 and even if it's 80, walking to the door to let the dog out jacks it up to about 105. I am very discouraged. I seemed to be doing so well.

Heart rhythm is normal at rehab. Blood pressure is fine: resting ranges about 115/70. BP recovers nicely after exercise but pulse takes much much longer. All arteries are supposed to be in good shape. Should I demand another echo? It seems to me that something is not as efficient in there as it was just a couple of weeks ago. Could one of the new leaflets have a problem? Would infection cause this? Cardio is not much help. Any thoughts or suggestions? Any websites that cover this? I've been searching.

Thankx!
Jack

 

[tobagotwo]

Obviously, it could be heart related. Your cardiologist will look into that. You are also still in the heart remodelling stage, so you may be in a temporary abberation window.

However, it may also be related to changes in the hypothyroid situation (was that secondary to amiodorone use?). I wouldn't rule that out. You may need an adjustment in your synthroid.

A lesser possibility is that you're coming down with a virus, which can have that type of effect. However, you didn't mention a cold or flu, so that's less likley right now.

Best wishes,

 

[jeffp]

Sounds about right for where you're at timewise. Many of us here had/have higher heart rates after surgery. I had about the same degree (more) of increase as you're having and took about 6 months to get down to the high normal range. Still waiting to get back to where I was pre-surgery in terms of heart rate. There's alot of time left for cardiac healing and remodeling. The poor thing's been traumatized and is likely less efficient per pump than it was, hence the needto pump faster. Your cardio can prescribe meds to lower the rate, but that's a whole 'nother story. Keep your exercise up, get rest as you need to and do well.

 

[Georgia]

My heart rate continued to decrease for nearly 2 years. It's finally at a really good place now. For over a year it stayed at 80 - 100. Now it's running 65 - 80. Much better.

 

[jax3172]

Yes - very bad cold!!!

Yes - very bad cold!!!

Thankx all for your excellent replies. Some additional info, as requested:

I don't think it's the synthroid - I discontinued for 4 days and it made no difference. And yes, I was on amiodarone from 7/25 to about 9/25. And yes Bob, I have my first cold post-op and it's a doozy! My cardio wants to see how I am after the cold subsides. Should I be worried about the cold for cardiac reasons??? Anything to look out for? I assume not.

A couple of other things: I discontinued bisoprolol 3 weeks ago (2.5 mg/day. It was such a tiny dose, I didn't think it was keeping my heart rate down by all that much. And my heart rate was lower (closer to surgery) before I went on the bisoprolol in early October.

The other thing that concers me is that i get tired just walking to the head when I was kicking but in rehab just 2 weeks ago. Any additional thoughts are appreciated but I guess I'll wait for the cold to run it's course and see whre I'm at. Thankx again, all.

Jack

 

[ALCapshaw2]

HNY Jack,

You may want to see if your Cardiologist is more receptive to another office visit / tests after the holidays. It does make sense to wait until you are over your cold. In the meantime, "drink fluids and rest", but keep an eye on fluid retention (press your shin bone, look for residual depression in the skin) and walk as much as you can reasonably tolerate, just don't push it.

MANY of us had elevated HR after surgery. Hopefully your cardio will work to moderate the effects with proper medication.

Best wishes,

'AL Capshaw'

 

[jax3172]

woke up out of breath

woke up out of breath

Al,

Thankx for the input. Yes, I will push my cardio for more tests. The cold is much better today but I woke up out of breath this morning. I walked about 2.5 miles yesterday. I tried again today but had to stop: Slow walking put me up to about 120 bpm feeling tired and out of breath. I do recover to 100 bpm after 2 minutes but as I write this, that where it's staying. I'm not sure what the problem is but something isn't quite right. I guess it'll resolve itself one way or the other. Heart rate seems to be going in the wrong direction. This stinks.

Any thoughts as to what could be going on here?

Jack

 

[Mary]

You might be concerned about a couple of different possibilities. I had both pericardial effusion and a pleural effusion at different times following my replacement on June 7. Both times, I had symptoms similar to what you're describing (shortness of breath and elevated heart rate). Is there any chance you're anemic? That will cause similar symptoms.
Mary

 

[jax3172]

Not anemic

Not anemic

Mary,

Thank you. No, I'm not anemic. What tests confirmed your effusion? And how did they treat it?

Jack

 

[Mary]

Mary,

Thank you. No, I'm not anemic. What tests confirmed your effusion? And how did they treat it?

Jack

Jack,
I had a MRI with contrast which showed the pleural effusion. At the time, I developed pain when taking a deep breath, and the PCP wanted to make sure it wasn't a pulmonary embolism. That was 7 weeks post-op.
The pericardial effusion was seen when they ran the 3 month post op echocardiogram. In addition, I had developed pericardial constriction (scar tissue on the pericardium which restricts movement).
In both cases, I was very short of breath and had trouble with increased heart rate.
I hope you can get this resolved soon.

 

[jax3172]

on way to hospital

on way to hospital

Mary,

I'm on my way to the hospital to get this checked out - may not be back on for a while. Thankx for the input. What did they do to get you better?

Jack

 

[jax3172]

back from hospital for high heart rate - more questions

back from hospital for high heart rate - more questions

I am very frustrated and don't know where to turn. I went to the emergency room because my cardio was unwilling to see me despite my continued elevated heart rate. They did X-rays, a CTScan (just what I wanted - more nukes), and a bunch of blood tests. They said everything looked fine and sent me home. What they didn't do was an echocardiogram. My cardio would be happy to do one in about a month! Also, the arterial blood gas test came back with an elevated HCO3 (bicarbonate: 28.5, normal is between 22 and 26) and an elevated SBEC (3.9, normal is between -2 and 2). Based on my research, a high bicarbonate can mean: chronic obstructive pulmonary disease (COPD), fluid in the lungs (pulmonary edema), heart disease, Cushing's disease (basically, too much cortisol), and Conn's syndrome. They did not even tell me about the elevated HCO3 (got a copy of my tests before I left) and, therefore, did not suggest any course of follow-up (like measuring my cortisol level). They just told me to see my cardio again. I have searched the internet and cannot figure out what an elevated SBEC means. I'm trying to get through to the emergency room on that one.

So after doing so great a few weeks ago, I continue to feel like crap, intolerant of exercise, and my resting heart rate continues to be in the 90 - 100 range. I wish I had access to real health care!!!!! Just venting. Comments appreciated.


Jack