High heart rate years after aortic valve replacement?

[Olive]

My husband is 36 and had his aortic valve & ascending aorta replaced almost 4 years ago, in Oct 2010. He was born with a bicuspid aortic valve.

Prior to surgery, his heart rate & blood pressure were normal.

After surgery, his heart rate was always high (low to mid 100's I think) at rest. He was put on beta blockers. He is also obviously taking warfarin.

His beta blocker, metoprolol, was at a dose of 50mg twice per day and this seemed to have brought his heart rate down to closer to normal, though still always faster than it was before surgery.

Over the past few months his heart rate has increased quite a bit - is now between 90-120 at rest.
His cardiologist doubled his metoprolol dose to 100mg twice per day (200mg total per day), this was about a week ago.

His heart rate has not decreased. Today he had a severe dizzy spell after standing up & experienced a few minutes of double vision & lightheadedness.

I was not home at the time but about 10 minutes after this episode i took his BP & HR - 124/86 BP and 118 HR.

He has had regular cardiac tests for years. All tests (echocardiograms, stress tests, etc.) all appear normal. He does have an abnormal EKG but Dr. says that is normal because of his artificial valve. (On-X prosthetic valve).

I am very worried that no Dr. seems to be able to explain WHY he has such a high heart rate all the time now. His overall health, diet, condition, etc, has not changed since before the surgery. He is not under increased stress. He is overweight (5'11" 190 lbs) but eats a healthy diet.

I've suggested that he cut back on caffeine (from 3 down to 1 cup of coffee per day) and increase aerobic exercise.

Do you have any input?


Thank you very much for any help.

 

[pellicle]

Hi

My husband is 36 and had his aortic valve & ascending aorta replaced almost 4 years ago, in Oct 2010. He was born with a bicuspid aortic valve.
...
that no Dr. seems to be able to explain WHY he has such a high heart rate all the time now. His overall health, diet, condition, etc, has not changed since before the surgery. He is not under increased stress. He is overweight (5'11" 190 lbs) but eats a healthy diet.
...
I've suggested that he cut back on caffeine (from 3 down to 1 cup of coffee per day) and increase aerobic exercise.

Can I ask what exersize regime he has done since surgery?

After my last surgery (2011) my heart rate was persistently higher for about a year. During at time I persisted in careful exersize and used a HR monitor. I got it back to resting rate of 68 but not without dedication. I believe that they call this now "remodelling the heart", but nine the less its not a given in my experience and takes work.

To this point however alcohol and caffeine make it hit 80 or 90 without much provocation.

My view is to work on health rather than rely on drugs.

 

[Olive]

Hi




Can I ask what exersize regime he has done since surgery?

After my last surgery (2011) my heart rate was persistently higher for about a year. During at time I persisted in careful exersize and used a HR monitor. I got it back to resting rate of 68 but not without dedication. I believe that they call this now "remodelling the heart", but nine the less its not a given in my experience and takes work.

To this point however alcohol and caffeine make it hit 80 or 90 without much provocation.

My view is to work on health rather than rely on drugs.

Thanks, pellicle!

His exercise regimen has been pretty dismal - maybe on average twice a week, 20 min on elliptical or light weightlifting. He very rarely drinks alcohol.

He agreed to do at least 20 every day on elliptical, and no more than 1 cup of coffee a day.

I agree with you that we need to do what we can to get his HR down naturally before turning to higher dosages of medication.

Thank you so much for your input.

 

[yotphix]

Just for kicks, you could also try mixing that one cup of coffee half with decaf once he is used to the one cup, then ultimately all decaf, just to take the caffeine more or less out of the equation. Do you find that the high resting heart rate is in the same range throughout the awake hours?

 

[pellicle]

Hi

His exercise regimen has been pretty dismal

Well like when we were kids exersize is critical to building a healthy body. When we have had some health issue crop up and tax that we need to go back and reinvest time in that again. Otherwise like our bank balances our levels can get low if all we do is widrawls.

He agreed to do at least 20 every day on elliptical

I have no idea what that is, but walking is great, if you can get some hills in there even better go every day, plan to keep hr at between 120 and 140. Walk as needed to keep this range. Time how long it takes to get from 140 back to 120 when you stop walking, this is a good measure of recovery rate.


Best wishes