Question for you old pros - episodes of noticably slower heart rate

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ARGreenMN

ARGreenMN

VR.org Supporter
Supporting Member
Joined
Mar 30, 2010
Messages
638
Location
Woodbury, MN (USA)
I know, I know - you guys aren't doctors. And I probably need to call one (again). And I will - but hate to bother them again on a weekend, so hoping I can/should wait 'till tomorrow... I ended up calling my cardiologist yesterday (sat). So let me run this by you guys and see if anyone else has noticed anything like this before... Or if it sounds to anyone like it's serious enough I should be calling 911 or something if it happens again...

I'm 2 1/2 weeks after surgery and everything has been going great (hope it still is). But the last couple days, something weird has been happening. Let me preface this by saying for the last week or so, I might have been getting a little over-confident, and maybe overdoing things a little. Haven't been getting as much sleep as I probably should and have gone out with friends the last 3 nights (only drinking diet pop, no alcohol except one beer Fri). And I just walked home from the bar tonight (25 min. walk - which cardio rehab WANTS me to do on my off days). But it was pretty hot/humid tonight and I was sweating pretty good by the time I got home. So this COULD be just because I'm over-doing things a little, but I'm getting a little nervous it may be more than that.

I think my "normal" resting heart rate is about 80 right now. I can hear my ticking valve very clearly, so it's easy to tell when it slows down, misses a beat, etc and also very easy to count my beats for 15 seconds, multiply by 4 and get my rate. But here's what I've had happen a couple times now in the last couple days. Just happened again a few min. ago (and lasted about 5 min). I imagine others have had skipped beats like I've always had (pre and post surgery - and the surgeon and cardiologist keep saying don't be concerned about that - it's normal). These "episodes" have started off with that - several skipped beats - a little more severe than normal. But then they turn into a very noticably slower than normal heart rate for a while (like 50-60 beats per min instead of 80). It feels "wierd"... It almost feels like it could be skipping every other beat. Then all the sudden, boom, it'll instantly start beating normally again (80 beats per min) - at which point I feel 'normal' again.....

Does this sound familiar at all to anyone??? Starting to get scared I may need a pacemaker or something???

PS - I'm on a beta blocker (Metoprolol) - 100mg per day to slow my rate, which I understand is a pretty heavy dose?

PSS - my cardiologist (who is very difficult to understand, esp. on the phone) I think ended up tellinng me yesterday to call the ER only if my rate gets over 100 bpm. But I might not have described the issue to him exactly right - I was more concerned yeserday with the racing heart rate I had right after one of these episodes, likely because I got scared...

Any thoughts???
 
There is a saying we have around here that hasn't been used lately, and that is "when in doubt, get it checked out"

It could be the Metoprolol, but you would still have to see your doctor to get the dosage changed.

If your worried/concerned on whats going on get it checked out.

Until then try to relax.
 
Was the pop you drank caffeine-free? Caffeine could cause irregular heat beats, especially this early in the game for you. Going out and enjoying some time with friends is good, not getting enough sleep is not good. Overdoing is not good. You still need your rest and good sleep at this point. I have no idea if you will need a pacemaker; you may need to wear a monitor for a few days to determine what the arrhythmias are and how often they occur and if anything other than a change in your medication is needed.

I would say call the doc now. It's better to err on the side of caution. If he's difficult to understand, tell him so and ask him to say it again until you do. I think it's also in your better interest to slow down a bit. You're still very fresh out of the gate!

Take care.
 
Irregular Rate?

Irregular Rate?

As others have advised, there's nothing wrong with checking with your doctor if you have concerns. Your surgery was pretty recent so things could still be just a little off. Metoprolol could be having an affect on you, but as you said, "We're not doctors here."

What you're experiencing could just be small bumps as your heart makes adjustments to your recent overhaul. Keep asking your doctor questons until he puts the answer in terms you can understand.

I noticed something of a heightened sensitivity to what my heart was doing during the weeks after surgery. I think that's pretty normal.

-Philip
 
Thanks!

Thanks!

Ok, thanks guys. That all makes sense, and I'm gonna call tomorrow. It's done the same thing a couple more times since my post - in fact it's doing it right now again - has been for about 10 min. There - just went back to normal when I sat up straight in the recliner. So, since I've made it through several of these tonight, I think I'll be ok 'till tomorrow. And I'm gonna try to get more sleep - it's just been hard for some reason... Anyway, thanks all!
 
ARGreen, The odds are in your favor that everything is OK, but just to be sure get it checked out. At least you will know that everything is cool and you wont have to stress over it. Will say extra Prayers for you and everyone else tonight just to stack the deck!!! Daren
 
And that could be a good point about caffiene... While I've always been a heavy caffiene drinker prior to surgery, I've been drinking caffiene free stuff 95% of the time since surgery - BUT - tonight at the bar, I had several regular diet cokes - not even thinking about the caffiene. Also wondering if my posture in this damn recliner could have something to do with it. I'm noticing that my diaphram area is sore when I stand up, especially after these episodes. Maybe from cramps 'cause I'm nervous, or maybe from not sitting up straight enough. Well, I'll get it checked out tomorrow. Good night guys.
 
The trouble with having a ticking heart is that you have a really heightened awarness of it's every beat, especially when it's brand new. Maybe you've just been overdoing it a little too ? I think a trenty-five minute walk after an evening socialising is probably pushing yourself a bit too hard after just a couple of weeks. I think I was barely getting around the garden at that point. You still need loads of rest. AVR is a massive operation and takes quite some getting over so dont rush it. Try not to panic too much about the heart beats either and remember, your heart has been mended, not botched, or patched or repaired but mended. Having said that, I second or third what others have said and say always ask a Doctor about any such concerns. Good luck.
 
Personally, I think your overdoing it right now and you may simply need a dose change of the medication. Doesn't hurt to mention it to the doc. You feeling faint at all? Your body is far from reshaped. It's going to do weird things for a few months yet.
 
What you are describing sounds like bigeminy (meaning every other beat) either pvc's or pac's. Of course you should check with your Dr. if you have any doubts, but if that is what you are experiencing, they are considered benign. They can make you feel like crap. I agree with Ross, you may be over doing it a little at this point and this is the way your body is telling you so.


Kim
 
I am 15 weeks post op and have similar erratic heart beats. A few weeks ago I did a walking stress test and the cardiologist said they would probably go away in time. I personally feel like there is something else going on as I do not seem to be improving with my attempts at running. I also have the odd dizzy spell as well. I am going to have a 24 hour heart monitor fitted next Thursday. One thing I have found is that it is very difficult to constantly take it easy due to my past fitness regimen. I have stopped listening to my heart beats as sometimes I can read too much into it.

Hope everything goes well for you.
Martin
 
Heart rate

Heart rate

I would be interested to know what your blood pressure is at night and morning. Mine is all over the place still after 16 weeks and my heart rate also alters from about 65 to around 90, my cardiac rehab have set my target as 105 to 130 when exercising.
 
Yep, sounds like a classic case of PVC's or PAC's (Premature Ventricular Contractions or Premature Atrial Contractions).

They 'feel like skipped beats" but in actuality are 'just' premature beats, close to the preceeding beat followed by a longer pause (which feels like a skipped beat). They are 'generally benign', but if they are occurring every other beat, they should be treated with an appropriate medication to get them under control. Avoiding Caffeine (and other triggers such as Stress, alcohol, un-prescribed drugs, etc.) will help to minimize the occurance of these palpatations. If your Cardio is unavailable (or difficult to communicate with), you might want to call your Primary Care Physician who should be able to help identify (and hopefully treat) this condition.
 
Update

Update

Thanks all - very helpful as always. Ended up going to the ER last night at 2 in the morn. The pattern I was seeing (irregular beats, followed by extremely slow beats for few min followed by an immediate jump back to 'normal') were getting worse and more frequent and I was getting scared. When got to ER, my heart rate was 43... Remember, my normal resting rate is about 80. They didn't seem too concerned, but I'm like - can a guy live on 40 beats a min??? They said, "we don't get too concerned unless it gets in the 30's".... WHAT!!!? I was 4 beats away from being in the 30's!!! Anyway, the 40's were hanging on now more often than the 80's so I was wondering if maybe that was gonna be my new rate and my heart was just getting used to it. That thought helped me get to sleep about 5 am. Well, at 6 am, they woke me up, and I was in full-blown "a-fib"... Gave me a new med "Amiodarone" which by 10 am had the a-fib under control (but from 6 am 'till 10 am was very nerve-wracking - being in a-fib constantly for 4 hrs...). They're gonna keep me overnight to make sure the new med keeps things under control. Oh boy, another med to take every day... But sounds like this one should be temporary (6 wks - 3 months).

As always, Ross was right... He warned Gil & I the other day we were getting too cocky. Boy oh boy, was he right (at least in my case)! Back to the drawing board ;) Well, not quite that bad, but it is a little disappointing being back in the hospital again - thought I'd seen the last of this place for hopefully many years a couple wks ago...

And I'm gonna take all your advice on scaling back my 'activities' a little - I knew myself I was probably over-doing it. They don't seem to think that's what the problem is - they think it's just fairly normal that when the heart and surrounding tissues heal, get swollen, scarred, etc. the electrical current can get confused. But it won't hurt to scale back a little either ;)
 
I do hope the Amiodarone is short lived. That stuff is supposed to be used only when all else has failed. It was never intended to be a first use drug, but that's exactly what they do.

Also be advised, Amiodarone will cause your INR to increase, so make sure to keep an eye on it.
 
Having trouble sleeping is very common after surgery. I'm guessing you've probably not taken many of your pain pills, but if they make you sleepy you might try that occasionally, or ask doc for sleeping pills. Totally agree with Ross that you're doing too much. I would stay off the caffeine for awhile, too.
 
He mentioned that he doesn't like this drug (told me about the possible lung issues long-term, etc.) but that in my case he thinks it's the best bet. It did seem to work... And he said he's fine w/ giving it to me since I should only be on it for a few weeks (or maybe up to 3 months). Yea, they're gonna watch my INR closely. It was 2.2 this morn (remember, my range is 1.8 - 2.2) so it probably will get out of range... Still doing good - nice & steady at about 75 bpm since 10 am this morn... Hope that continues! Wasn't a big fan of a-fib!
 
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