Heart rate - excercise-problem

[Mb]

Hi!
I wonder if you all could provide some input. My husband (9 weeks post op), is at cardiac rehab (55 yrs old). He has been 9 times. Out of those 9 times, they have had to call his Dr. I think 7 times, as his heart rate goes high. He walks for 12 minutes at 2.4 MPH (don';t laugh, thats all he can do), then on the bike for 12 mintes at 1.4 MPH. His heart rate spikes up to 160-190, they tell him to slow down.......etc. He is now on 4 attenenol, digoxin, lasix, aspirin, etc. a day. (med changes about 6 times in the past nine weeks.)
Here is my question. What is a "too high" heart rate? Has anyone else had this experience so newly out of surgery? I've searched the net for info on heart rate.....but no luck. Oh, he is in a-fib, and had AVR and MVR done on 10/3/01.
How does he feel? Well, the days he goes, at the end, he just about falls over, he is so tired. (probably normal). But Wed. of this week he got pretty dizzy., Any info on heart rates, etc. would be appreciated.- Marybeth

 

[Perrster]

Patience

Patience

Marybeth,

Being only 9 weeks post-op, I think your husband should give himself a lot more time before things (and his heart rate) can "stabilize." I don't know if that's a cardiac medical term or not, but I do know that Rehab takes a LOT of time and patience. He must re-build his strength slowly.

He could possibly inquire about limiting his re-hab to other strength building routines that don't affect his heart rate so much? Perhaps once the medication is settled in, then he can slowly return to the cardio routines? I'm not a re-hab expert, but I would think everyone could work together and come up with an alternative program?

I remember being scolded in re-hab classes because I wanted things to go faster than they were. I expected magic right away. I'd go too hard at something and they'd slow me down. Your husband's problems sound more serious, but they're doing the right thing by calling the doc.

I think all of us react differently to the medications (which can also have adverse effects on heart rates), exercise, and our new "lifestyle."

Heck, I'm 20 months post-op and just about now got the heart rate and exercise routine down pat. I'm 51 yrs. old. This week I'm signing up for the 40+ basketball league which starts in February. It was a goal of mine from the beginning and it really took me this long to get here.

There really is a ton of heart rate information on the net. If you use the "Google" (www.google.com) search engine and type in heart rate, you will get over a million links. Try this web link for more heart rate info. from the AHA http://www.justmove.org/fitnessnews/hfbodyframe.cfm?Target=hartrates.html

Also try a "google" search of the exact medication names to get side-effect info. I got my Digoxin info that way. Most of mine state fatigue as being a side-effect.

I hope some of my feedback here has helped? Have patience, time is on your side.

 

[Nancy]

Hi Marybeth-

Joe is doing 2.2 mph on the treadmill and going a mile and a half. He wants to be able to maintain a half hour on the treadmill, no matter what the speed for the aerobic benefit. He said his target is 2.3 by next week. 2.4 mph is a pretty good clip for Wayne so soon out of surgery. When I'm on the treadmill, 2.5 is a very fast walk for me, with short legs, and at 3.3 I'd be jogging and at 4 running.

Hope the doctor can get to the bottom of the rapid heartbeats. It must be related to his afib.

Send Wayne our best. He's really trying and that's great!

 

[RobThatsMe]

Hi MaryBeth,

The following link has some useful information regarding Heart Rate and Exercise. I tried to paste the info here, but the chart gets confused in the process. The link is:


http://www.fitresource.com/Fitness/HeartRat.htm


However, if he is on a Beta Blocker, none of this should apply. The rule for a Beta Blocker user is Resting Heart Rate Plus 20 to 30 beats is optimal.

Here is somemore information regarding Beta Blockers and exercise.

Topic: Heart Disease: Laurie Anderson, RN, BSN >> Discussion: Exercise with
low pulse from medication (by Arlyp (WebMD))
Re: Exercise with low pulse from medication
by ljandie91 (WebMD), 8/18/00 10:09 PM
Hello,
Your heart is getting an adequate workout as long as you raise it 20-30 beats
per minute over your resting levels. You can't calculate a target heart rate
based on the traditional method of subtacting your age from 220 and
multiplying it by 70-85%, because of the beta-blocker.
In the cardiac rehab setting we usually use 70-85% of the highest heart rate
achieved on the pre-exercise stress test, if the medication(s), especially
beta-blockers, were taken before the test. If the medication(s) were held,
the highest heart rate achieved must be further adjusted for these meds;
typically a range of 10-20% more depending on the size and frequency of the
beta-blocker dose and the dose(s) of other medications being taken that may
also be lowering the heart rate. Sometimes this method of calculation is
ineffective; in this case we often use the simple formula of resting heart
rate plus 20 to 30 beats per minute. This range is decided upon based on
whether or not the person is still ischemic (blockages that are preventing
adequate blood flow to the heart), the amount of heart muscle damage from the
heart attack, the ejection fraction and other individual considerations.
In regard to your question about time of day to exercise, in my opinion you
are actually better off to exercise earlier in the day, when your
beta-blocker is having the most efffect on your heart rate. I can't evaluate
this in relation to your condition, because I don't know what the situation
is with your heart's blood flow. In general the effect of the beta-blocker is
to improve blood flow to the heart muscle, so it is better protected from the
potential effects of decreased blood flow and thus you are less likely to
have angina. Hope this is clear and helpful; I will watch for additional
posts from you should you have another question.
Sincerly, Laurie Anderson, RN, BSN

 

[Kevin M]

I had a similar, though not as drastic experience.
I was fine when I was on the beta-blockers. My heartrate was about 120-130 with a walking a pace of 3.0-3.5mph. I'm 35 and had been exercising pretty regularly pre-op with no other medical complications.

The very day after I went off the beta-blockers, my heartrate shot up to 140-155. I got a little worried, so I slowed the pace and started all over again.

We all heal at different rates. I too had some pretty nasty dizzy spells and felt exhausted. It worried me because it reminded me of my pre-op symptoms. It turned out that in my case, I just needed more time than I expected to recover.

I'm now 5 months post-op and run at around 4.6mph for 30 min. with a few 2 minute bursts of 7.4mph (10kph). I find my body can easily accomodate this but my cardiopulmonary system feels labored and I'm consistently in the 140bpm-170bpm range (the 170 only during the 7.4mph).

I feel I may be pushing myself too much sometimes, but overall, I try to listen to my body. I got very frustrated in the first couple of months because I wasn't able to do anything without increasing that heartrate.

I think Perry's comments make a lot of sense. Patience is the key. As long as the doc's are aware and they and you can keep a close watch, they should be able to identify if there's a problem.
Kev

 

[maxximom]

Hi
I am 10 weeks post op I had a AVR and triple bypass on Sept 23. I started rehab 2 weeks ago. I go 3X aweek to Duke. There are no classes..everything is individulized for each person. I was is terrible shape before surgery..I couldn't really do any excersise before..walking was a big problem for me..so at rehab..I have to go slowly. I am also 70 years old and have fibromyalgia..so any stressing of my muscles can be painful. I am doing thwee treadmill at 1.8 Miles per hour for 15 min and will gradually increase it. I also use a great peice of equipment called a Nu-step..sort of a sit dowm sepmaster for 1/2 hour. I just started working out on the weight equipment on Monday aand tomorrow will start working out in the pool. I have been fortunate not to have AFib. It sounds loke your husband is working out at to fast a pace. Who designes his workout program for him? It may need to be re-evaluaaated if he is having so many problems. Plerase check back with his cardio doctor or have the rehab people consult with him. Re hab is important..but you don't want to do damage!! Good luck
Joan

 

[Mb]

Thank you to all who posted. The info is invaluable. I've copied it so Wayne can read and discuss with his cardio.

Add'l info: Wayne is 6'3", so walking at 2.4 MPH is pretty slow for him. He also just "graduated to that. He was at 1.9
His heart rate goes as high as 190. Needless to say, they stop him, and will have him on the monitor all of the time. He now takes three attenenol in the morning and one at night. He is quite short of breath when walking up a flight of stairs. But, we need to see how the new med adjustment works out, I guess. They just increased the attenenol on Wednesday. Nancy, I think you comments about the a-fib are correct. I do think it is related. His resting heart rate is about 80, which is great. However, last night, for example, he was watching TV for about an hour, walked into the kitchen, sat down. I took the heart rate, and it was a wee bit over 100. His EF was 40% pre surgery. He has angina only occasionally. I think Joan's comments about slowing down the pace of rehab is probably right on. Will let you know how he makes out over the next couple of days. Thank you all SO much.
The info about HR and beta blockers was interesting. That would put his highest heart rate at 110, which obviously isn;t happening upon even modest exertion. But, we need more time.
Again and again...thank you. - Marybeth

 

[sylviayasgur]

hi marybeth!
my husband joey is 11 weeks post op and had a similar thing happen while still in the hospital. he went into a fib at random times (not just when standing or moving) and his heart rate went up to about 180 or more. when he was not in afib, his heart rate slowed down into the 70's. he was taking sotolol for the afib pre-surgery and this did not help at all to keep them at bay. so, they have him on amiodarone and he is on it for about 2 more weeks. this_thank God_ has really been great and kept him in sinus rhythm. he just started running on the treadmill last week (he had been walking all this time) . i know his heart rate stays low (130 max), but he's in phenomenal shape and was a runner before his surgery. joey is also one of these people who is determined to get "back to feeling as normal as possible" he has very little patience for these things, which posed a big problem in the beginning when he wasn't up to much activity.
we both think the amiodarone has allowed his heart to relax a bit. the dr explained it to us this way: your newly repaired heart doesn't realize that it doesn't have to work as hard anymore, soit just gets carried away sometimes.
amiodarone is very strong medication from all i've read about it and from what folks here say about it. it has, however, been great for joey and he is being very closely monitored for side effects.
it took him awhile to feel better and, for him, maybe the magic number was 10 1/2 weeks, but things are finally falling into place. please be patient.
i wish you both the best of luck and hope all turns out well. please keep us posted.
-sylvia

 

[Jean]

Heart Rate

Heart Rate

Rob,

Thank you for the interesting article on Heart Rates for people on Beta Blockers.

I did not get put into Rehab after my surgery 2 years ago...I didn't even know about it. Later when I asked my cardiologist, he said I was in such good shape and was active anyway that he didn't think I needed it?

I did do walking and light farm work, but what has bothered me is that I know what my heart target rate was prior to surgery doing the years old and the math, but I could never get up to that rate since surgery. I had been pushing for 140s, but could hardly get to 110.

According to your article, I should be at about 100 to 110, so I was doing fine.
And what I really like about aroebic exercise now is that I can really push it and when I stop, I regain my breath in about 20 seconds where I would be gasping for minutes prior to surgery -- shoot -- prior to surgery, I couldn't breathe period!

Thank you for the article.

 

[Gail in Ca]

I am 1 1/2 years out of my second AVR.
I know that when my heart rate has climbed to over 140 in arobic class or on the spinning bike, it's just too much and I begin to feel not right, sort of bad, and then slow down immediately. I really listen to my body and rarely get it up that high now. I take cozaar, an ace inhibitor type drug. My resting rate is 60. I try to only get the rate up to 130 at the most, and feel fine there.
Oh, I'm 47, and sure can't exercise like I did after the first surgery when I was 34!!
Gail