Maximum heart rate for exercise purposes?

[MitralMan]

Tomorrow I'm 4 months post-op; I've been exercising regularly with increasing intensity and duration for the last two months.

Are there any rules of thumb for maximum and target heart rates adjusted for surgery and medication (i.e., Metoprolol)? My max used to be about 176 (I'm 48), and I would exercise up to about 165bpm for short intervals. Now, I don't let my heart go above 143, but I'm not sure it would in any case.

Thanks!

 

[PapaHappyStar]

Hi,

I am 32, and I have begun biking around recently at around 4 months post-op as well -- my max. HR is around 195 and I get my heart rate to 170 rather easily at the moment -- I have hit close to 180 on occasion.

I had talked to my cardiologist when I first started aerobic exercise ( I was hitting the ball on a squash court 2 months post-op ) and got upto 170+ really easily but couldnt get down to below 90-100 bpm for hours after exercise and he recommended taking it easy for a while. Even now my heart rate comes down a bit slower than I would like, but I am around my normal resting rate after around an hour.

I was on a beta blocker for a month post-op for high HR but have discontinued it so I dont know how this would affect max. HR -- mine hasnt seemed to change since after surgery and discontinuing the beta-blocker though.

Regards,
Burair.

 

[ALCapshaw2]

I suspect you know the 'Standard Rule of Thumb' Absolute Maximum is 220-AGE with Target ranges up to 80 or 85% of that number. Your 143 target 'sounds safe' but best to check with your cardiologist, just to be 'more safe'.

'AL Capshaw'

 

[ALCapshaw2]

My first reply seems to have been lost.
146 'sounds safe' at your age, but best to check with your cardiologist. A phone call suffice for this basic information.

'AL Capshaw'

 

[BillCobit]

Tomorrow I'm 4 months post-op; I've been exercising regularly with increasing intensity and duration for the last two months.

Are there any rules of thumb for maximum and target heart rates adjusted for surgery and medication (i.e., Metoprolol)? My max used to be about 176 (I'm 48), and I would exercise up to about 165bpm for short intervals. Now, I don't let my heart go above 143, but I'm not sure it would in any case.

Thanks!

Hi Mitral Man -

A few years ago I went on a hunt for that same info -never found it - just the same "0.8 x 220 - age" advice. I once read an article by a dr. that said "220-age" was equivalent to "average shoe size is 9." - statistically correct for a large population, but useless guidance for someone trying to buy shoes. I found that 220-age didn't allow me to run or cycle up hill,so I just used my personal comfort level, which equated to:

120 - I could do this all day
130 - I can tell I'm exercising but this is comfortable
140 - it's work, but I still like it
150 - I can go a few hours
160 - looking forward to stopping
170 - I gotta stop now!

So I guess my shoe size is 10??

I'm approximately same age as you, but w/ no meds. My doc could not provide any useful guidance, except that 170 sounded too high (same thing my body thought!). In absence of any meaningful guidance backed by rational explanation, I just sought a tolerable comfort zone. I did find that over the past couple of years my HR has dropped about 15 beats for similar level of exercise. Resting HR continues to be about 80, while it was high 50's below surgery.

Please post the "right" answer if you find it. Many of us would be interested in reading it.

Best wishes for continued recovery.

Bill

 

[tommy]

I've seen "perceived exersion" used as a guide. Bill, I like your chart. Also, varying your heart rate teaches it to be flexible and may be more healthy than just staying in one gear all the time. Absent some other issue, I think that going "uphill' now and then is okay, but don't stay in that range for long.

For recovery, I've tried to get down to 100-110 BPM three minutes after exercise. If I don't recover that fast, I should take it easier next time, and increment gradually from there.

Another guide is your resting heart rate. Following surgery I was around 100 BPM. Over several months it dropped to the 70's. With regular exercise, it eventually has settled in the 50's. I've laid off with some injuries, and I see it creeping back up.

Frankly, 4 months post op, I would not want to get close to maximum heart rate. Maybe that's just me. I did surgery in poor fitness and started rehab from scratch. You guys are awesome.

 

[PapaHappyStar]

Should add that I dont keep a careful watch on my HR when I am cycling but notice I am at 170 biking into the wind without pushing extremely hard. Maybe I should keep it a bit lower but I tend to get bored biking too slow!

I think I am at around 85-90% ( anaerobic threshold -- start to breathe heavily and feel the burn ) at 170-180 bpm -- so I estimate my max HR to be around 195 bpm.

 

[epstns]

Bill and everyone,

I'm still pre-op, but when I discussed the max heart rate issue with my cardio, he gave me the "common sense" advice of "if it feels OK, it probably is OK." So, most of the time I run my rate up to the low 160's. If it feels OK, I stay at that pace. If it starts to feel like I'm trying too hard, slower we go. I rarely ever let it get to the mid or upper 160's, and then only until I can slow down. My resting HR is around 60, and one minute after slowing down the treadmill, I'm down 35-40 clicks from max. So far, so good -- but I'm intensely watching for any changes, and would call cardio for advice.

 

[MitralMan]

I realize that I'm actually fearful...

I realize that I'm actually fearful...

of blowing a leaflet or tearing another cord (which I'd done before) from over-exertion.

My resting HR pre-op (say a year before pre-op) was around 54. Now, it has just broken 70 and heading down for the first time (my resting HR until recently post-op was high 80's/low '90's.

I used to feel fine at 140 for extended lengths of time; my 2001 marathon pulse averaged 150. Now, I don't feel badly at 143, but I pull myself back down.

I'll let you know what I find out!

Thanks, all!

 

[PapaHappyStar]

My resting heart rate is still higher than pre-op as well. It was around 55 pre-op and is around 70 right now. I did not start exerting at exercise until a cardiologist here in chicago told me that most young people start "treating their bodies like they were made of glass" after OHS. My situation is different from yours perhaps I had a bicuspid aortic valve and my surgery is in a lower pressure/risk area than yours.

I think I labor a bit too much at the moment at fairly moderate levels of exercise -- I am trying to bike at an easier pace until I feel more comfortable but often lose patience. I dont think I will do any permanent damage though even at 80% of max and dont feel unduly uncomfortable at this level even though I dont recover as quickly as I want to -- I should check with a cardiologist though...

 

[MitralMan]

I DO know that during cardiac rehab...

I DO know that during cardiac rehab...

The staff, in consultation with my cardiologist, started me at 20-30 bpm above resting HR, which placed my target at a maximum of 115. They subsequently (again in consultation with the cardiologist, based on my response to exercise) bumped the target to 40-50 bpm higher than resting. This put me at a target of 125, as my resting HR had started to come down.

I finished cardiac rehab just about two months ago.

Does anyone else get paranoid like this: my resting HR has been dropping slowly but steadily, but then last couple of days it's up 10bpm. I worry: I've over-exerted and damaged my newly-repaired valve. What my brain tells me: you finally caught the cold that everyone else in the house has had, so what do you expect??

 

[ALCapshaw2]

My resting heart rate is still higher than pre-op as well. It was around 55 pre-op and is around 70 right now. I did not start exerting at exercise until a cardiologist here in chicago told me that most young people start "treating their bodies like they were made of glass" after OHS. My situation is different from yours perhaps I had a bicuspid aortic valve and my surgery is in a lower pressure/risk area than yours.

I think I labor a bit too much at the moment at fairly moderate levels of exercise -- I am trying to bike at an easier pace until I feel more comfortable but often lose patience. I dont think I will do any permanent damage though even at 80% of max and dont feel unduly uncomfortable at this level even though I dont recover as quickly as I want to -- I should check with a cardiologist though...

AH, the "Impatience of Youth"

or is it just the 'male thing' ,
wanting to be 'back to normal'
and 'in charge'.

Been there, done that, and almost got myself in trouble by 'overdoing'. Recovery just takes time, more than we would like, BUT, it is best to TRY to be patient and not do anything foolish to set it back. SLOW and STEADY wins the race, even if it is B O R I N G...

Patience Burair, Patience

'AL Capshaw'

 

[PapaHappyStar]

AH, the "Impatience of Youth"

or is it just the 'male thing' ,
wanting to be 'back to normal'
and 'in charge'.

Been there, done that, and almost got myself in trouble by 'overdoing'. Recovery just takes time, more than we would like, BUT, it is best to TRY to be patient and not do anything foolish to set it back. SLOW and STEADY wins the race, even if it is B O R I N G...

Patience Burair, Patience

'AL Capshaw'

Yeah, its probably ego. Its pretty hard on one to lose the carefully cultivated sense of machismo and invincibility when you get news of a heart problem. I was slowing down a bit even before I knew of the AS, this prompted me to give up on exercise rather than accept slowing down -- was pretty depressing. The good part of it was they found the problem and measured its severity just in time.

I guess I am trying to heal in more ways than just physically....

 

[PapaHappyStar]

The staff, in consultation with my cardiologist, started me at 20-30 bpm above resting HR, which placed my target at a maximum of 115. They subsequently (again in consultation with the cardiologist, based on my response to exercise) bumped the target to 40-50 bpm higher than resting. This put me at a target of 125, as my resting HR had started to come down.

I finished cardiac rehab just about two months ago.

Does anyone else get paranoid like this: my resting HR has been dropping slowly but steadily, but then last couple of days it's up 10bpm. I worry: I've over-exerted and damaged my newly-repaired valve. What my brain tells me: you finally caught the cold that everyone else in the house has had, so what do you expect??

I think its natural to get worried -- they do instill a bit of paranoia in you in the hospital ( and probably in rehab too -- although I didnt sign up for it ) -- guess they are right and if anyone is justified in becoming a worry wart of sorts you and I are. I think one has to at some point ask oneself would I have worried about this change in my measurements before surgery -- if one can stop worrying at that point I think one would be more or less healed in psyche too.

If you get overt symptoms -- I would report it to the cardiologist or a cardio physical therapist, for example if I suddenly start feeling fatigued without too much exertion...

 

[Mary]

I just viewed this thread for the first time, and you all have got me a little concerned.
Before the aortic stenosis was discovered, about 4 years ago, my resting HR was about 55-60. It now runs in the mid to high 70's. I assumed after surgery it would return to normal, but that's not what I'm reading.
Why doesn't it (with the exception of Tom H. who started working out after surgery)?

 

[PapaHappyStar]

I just viewed this thread for the first time, and you all have got me a little concerned.
Before the aortic stenosis was discovered, about 4 years ago, my resting HR was about 55-60. It now runs in the mid to high 70's. I assumed after surgery it would return to normal, but that's not what I'm reading.
Why doesn't it (with the exception of Tom H. who started working out after surgery)?

I dont know exactly why but it seems to be a common phenomenon from what everyone's been telling me, the heart rate gets elevated post surgery. Mine might have had something to do with an accident in the CICU which led to an overdose of fluid for blood volume and I've had "tachycardia" -- high HR -- since. It was around 120 in ICU and came down to around 100 when they discharged me and has slowly crept down to around 65-70bpm at the moment, but I think its on its way down still as I regain fitness. Its not something I would worry unduly about -- I do feel better ( more energy ) since my surgery otherwise.

 

[MarkU]

I had a congenital BAV. Pre-Op I was doing a lot of heavy weight lifting, with a little bit of aerobic exercise thrown in. Prior to surgery it was discovered that I had developed some left ventricular hypertrophy. My resting HR was 70-72 bpm.
Post-Op (mechanical), I gave up the weight lifting and got into extensive aerobic training for triathlons. I work out five to six days per week, rotating swimming, biking, and running sessions. I have tried use my HR to guide my workouts in order to stay just below my anaerobic threshold (about 140 bpm for me based on the age formulas). In the past 1-1/2 years my ventricular enlargement has reversed itself and my resting heart rate is down to 47-48 bpm. Last check of my blood pressure was 104/70. I'm pleased with those numbers.
I think my new exercise program has made all the difference in the world in my particular situation - I had always been active, but not always in "healthy" ways. I also think my improved post-op diet has helped.
My biggest health worry at this point is not my heart, but the pre-cancerous polyps they seem to keep finding in my colon (getting ready for my third colonoscopy in three months).
Mark

 

[MitralMan]

Mark, GREAT numbers; Mary, I think HR does lower over time

Mark, GREAT numbers; Mary, I think HR does lower over time

Like I wrote earlier, my resting HR used to be low '50's, was 90+ immediately post op, and has come down to just below 70. My goal is to emulate Mark and hosacktom, and get it back down into the '50's.

Papa, I hear you -- hey, if anybody ought to be thinking about things like this, it's us.

But having vented through this thread, I'm OK with it. Like Al says, slow and steady...but with that dang'd pace boat functionality on the PM3, I keep insisting that my time improve week over week...

 

[Jean]

Had my surgery AVR in 2000 - Jan. Prior to surgery my rhr was in the 80s ... had always been there every since I was running and doing fitness. After surgery, it was still high, but within a few months started dropping. Now after 5 years, I am in high 50s/low 60s.

 

[Raverlaw]

My HR has gradually dropped since the surgery and with regular exercise. at 50 years old, I try to keep it around 145 for sustained exercise, with little bursts up to 150-55 once in a while for variety. I do could 135 for hours. I'm with Tom - if my HR doesn't get back below 100 after three minutes off the rower, I know I've over done it for the day.

A week of long work hours, travel or a minor cold will also raise my resting HR about 5 beats. Right now, my resting HR is around 60.