Exercise & Heart Rate

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Unicusp

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Joined
Jan 30, 2021
Messages
374
Hello - Thought I'd share some interesting info on high HR during exercise and get some feedback/comments. For background, I had an On-X aortic valve installed back in Feb 2021, and a Dacron graft to replace ascending aorta back in 2013.
I'm curious how dangerous (or even if dangerous) high HR is and what potential damage can be done. I wear a Galaxy 2 watch for recording HR and other data. I also do a weekly health check every Sunday checking: INR, PT, HR, Oxygen level, and BP. Results yesterday were: BP - 127/81, HR - 57, Oxy - 99, INR - 2.5, PT - 27.9
At my age of 61, target max HR should be 159 (according to the MHR method). Using my Galaxy fitness app I'm able to see maximum HR and average HR during exercise. I'm in very good shape but get alarmingly high HR's when exercising. Yet, I do not feel different or have any symptoms during the high HR's. I do regular breathing during exercise and never hold my breath. I'm back to my pre-surgery exercise routine which includes': stretching, abdominals, different weight exercises (high rep/medium weight), inversion, and elliptical (usually for 45 min) total around 1.5 hrs.. Also do daily walks on hilly terrain and do anywhere from 8k to 15k steps per day.
Yet, I've seen HR's as high as 205 and averages in the 150's to 160's. Yet, I feel good throughout and do not feel light headed, shortness of breath or faint during.
Does anyone else see such high numbers? Any comments? Thanks.
 
I'm curious how dangerous (or even if dangerous) high HR is and what potential damage can be done
I was told the risk is an aneurysm in the unrepaired portion of your aorta from potential high blood pressure at a high heart rate.

I have an appointment with a sports cardiologist to discuss how to mitigate that risk while still being able to participate in activities with a high heart rate. Some strategies that we'll be discussing:
  • Exercise testing at max heart rate to confirm blood pressure isn't dangerously high.
  • Surveillance via CT or MRI to watch for aneurysm growth.
  • Continuing Metropol to keep exercise heart rate and blood pressure down.
  • Putting a self-imposed heart rate limit on exercise.
  • Others?
 
I'm not convinced of the accuracy of fitness trackers/watches in determining heart rate. My max HR is supposed to be about 160. Yesterday I did an interval workout with 130 average, 154 max. Last week I did the same workout with 132 average, 188 max. I am suspicious of the 188 reading. This is on a Fitbit. I think the heart rate monitors with chest straps are the gold standard.
 
I think the heart rate monitors with chest straps are the gold standard.
Even chest straps frequently give spurious readings.

Whatever you are using, stop and manually measure your pulse for 15 seconds if your heart rate seems off relative to your perceived exertion. Over time you'll grow to recognize when the readings are wrong.

This is from a run the other day wearing a Garmin chest strap where the first third was wrong:

1670380994067.png

I think the particular shirt I was wearing gives off static that throws it off. It wasn't until I started to sweat that the chest strap had good conduction. I took three little walk breaks to see if my HR came down and check manually. Only the second two walk breaks registered on the watch and had a correct manual check. I have electrode gel that I should have used to avoid the problem.
 
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Those max heart rate charts are certainly not accurate for me at all in terms of perceived effort. According to them my “vigorous” exercise range is 128-152. I’m not breathing hard or even sweating till I get to 156 or so, and 165 is supposedly my max rate (I’m 55). And I am definitely not in great shape, so it isn’t that.
 
I think the heart rate monitors with chest straps are the gold standard.
even there there are issues with good connections all the times making it hard for the simple algo to not make mistakes.

adhesive pads would fix that, but who wears that except when researchers are involved
 
I had a nice, quick conversation with my sports cardiologist. He ordered a maximal exercise test (on the bike) to see how my newly upgraded (six months) heart performs at high heart rates.

Until then, I need to stay below 130-140 bpm, a level where he's comfortable my BP won't be a problem since I was fine there during cardiac rehab.

He also suggested annual surveillance to keep an eye on my aorta and to stay on Metropol as tolerable without side effects.

No racing for now. Not a problem as I can base train at 130-140bpm until after the test. It will take a while to get in for the test, so I'll train for the test in the meantime. (y)
 
Unicusp - It is a mystery to me that with exercise that pushes your HR to your max of 159 and past that you are not feeling great discomfort. Feeling comfortable without excessive breathing or fast heart rate is indicative of easy aerobic exercise such as walking and some of the other things you mentioned, but that being the case your heart rate should only be sitting around 110-130. In other words, unless you push well into an anaerobic (without oxygen) threshold, running very hard for instance, your breathing and your HR will increase dramatically and work in concert together to provide enough oxygen rich blood to your working muscles, in this case the quads, hams, and calves, and of course your heart muscle. It's basic exercise physiology and there is no way around it, at least in the absence of performing enhancing or performance limiting drugs. I've been running and racing long enough that I can predict very precisely what my HR is based on my pace and perceived level of exertion. And now with Smart watches it is very easy to monitor and verify. As someone mentioned, many of these devices are not always accurate so sometimes if readings seem way off, like your experience with high HR and no discomfort, I would first look to a mechanical problem because it just doesn't make sense, unless of course you are the real Superman. And to answer you question, I am about your age with a similar Max HR and the highest I have gotten it in recent months was 175 during a sprint finish of a 5K, collapsed on the ground, and thought I was going to die while withering in pain. I will not push myself to that limit again just to be on the safe side. As it is my cardiologist knows I run and doesn't even want me to hit my max of 156, which I think is being overly cautious because he has no fact based evidence that it is detrimental to my mechanical mitral valve.
 
Thanks for the insight and feedback. I wore a chest strap today on the elliptical and while doing weights. Compared those readings to my "dumb" watch. Noted significant differences. The watch seemed too high (150's) and the strap too low (100). And I was on a variable hillclimb for 45 minutes. Next I've got to try one of my old Fitbit's and compare the 3. Crazy!
Yet when sitting relaxed and comparing HR on watch to BP device and Oxygen device they all match perfectly (55 to 60 range). Thanks again! On-X is performing well.
 
@Unicusp, I'll bet the strap is correct over both watches, especially if you saw consistent readings throughout the workout. Here are a couple of suggestions for investigating further.

This is the electrode gel I use on the chest strap contact patches:
https://www.amazon.com/gp/product/B00AMGV010/
If you use that gel and have the strap tight, the reading should be correct, like 99% or more of the time.

And to verify, stop for 15 seconds and check manually:



I'm not surprised everything matches up sitting at rest, as the motion of exercise throws off the sensors.
 
I was curious after this discussion and I found some different formulas online:

There are many formulas for calculating your maximum heart rate, however, the most studied are the following:
  • Fox formula (most common formula for men and women): 220 - age
  • Gulati formula (women only): 206 - (0.88 × age)2
  • The HUNT formula (men and women who are active): 211 - (0.64 x age)
  • Tanaka formula (men and women over age 40): 208 - (0.7 × age)
I dunno what they mean by "active," but I get 176 as a max rate for me using the HUNT and that seems believable to me as I don't think I've ever exceeded 173 on the (few) occasions I track HR. It also said that people with smaller bodies (I'm 5'4") tend to have a higher max heart rate which I had not heard. I don't have any doctor-imposed restrictions so hopefully I can just keep determining intensity based on perception.
 

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