Tennis and beta-blockers ??

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A

Alex

Hi,

I am 37 and I had Aortic Valve Repair 8 months ago. I posted this as a reply in the cardiac rehab forum but I'd like to know if there are any competitive tennis players that can share any experience. I was a very competitive player prior to surgery. I can bike decently and running is OK too ( not like before surgery though) but tennis is very exhausting and that is driving me crazy. Even though I am on carvedilol ( now they have increased the dose to 18.75 mg twice a day) my heart rate still goes up too much while playing tennis and I can hit more than a few shots before my heart gets to over 160 and I start not feeling well, getting PVCs, tachycardias and I even got an episode of A-fib. This doesnt happen biking or running. I love tennis and I just can't play. The weird thing is also that at five months after surgery I seemed to handle tennis better, I didnt get so tired, I dont know if my heart is getting worse or this medicine has stopped working, or I need a different med or maybe I dont need it or what...

If anyone is a tennis player or has any similar experiences with other sports please share... it is much harder for me to live without my passion, I should be happy for being alive, maybe I am spoiled but I need to play again !

Thanks in advanced for any info you can share...
 
M

Mary

Hi,

I am 37 and I had Aortic Valve Repair 8 months ago. I posted this as a reply in the cardiac rehab forum but I'd like to know if there are any competitive tennis players that can share any experience. I was a very competitive player prior to surgery. I can bike decently and running is OK too ( not like before surgery though) but tennis is very exhausting and that is driving me crazy. Even though I am on carvedilol ( now they have increased the dose to 18.75 mg twice a day) my heart rate still goes up too much while playing tennis and I can hit more than a few shots before my heart gets to over 160 and I start not feeling well, getting PVCs, tachycardias and I even got an episode of A-fib. This doesnt happen biking or running. I love tennis and I just can't play. The weird thing is also that at five months after surgery I seemed to handle tennis better, I didnt get so tired, I dont know if my heart is getting worse or this medicine has stopped working, or I need a different med or maybe I dont need it or what...

If anyone is a tennis player or has any similar experiences with other sports please share... it is much harder for me to live without my passion, I should be happy for being alive, maybe I am spoiled but I need to play again !

Thanks in advanced for any info you can share...
I went back through the archives trying to find an answer for you, but I didn't find much. One member had difficulty with SOB playing tennis, and she was about 7 years out of mitral valve replacement at the time.
But that's not heartrate.
There is another website called cardiac athletes that I would suggest you look into. Several VR members who frequent the active lifestyle forum belong to cardiac athletes too, and there are alot of folks over there that are more likely to be able to help you.
www.cardiacathletes.org
 
A

Alex

Thanks so much for researching it for me. There are truly special persons in this forum ! Thanks again !!
 
S

Susan BAV

Alex, have you had your mineral balance checked recently? Particularly because you've probably been perspiring all summer...

FWIW, I have been having PVC issues and my cardio said that for people who tend to have arrhythmia episodes, it's better if their potassium and magnesium levels are higher than where mine were reading. He put me on some minerals and suggested I consume electrolyte fluids when I perspire. I'm feeling better, evidently from the minerals.

Also, you're only 8 months post-op and will no doubt feel even better as more time passes :) .
 

cday

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May 31, 2008
Messages
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Location
Tyler, Texas
Alex,

My husband is a 4.5 level tennis player (AVR in May) and I have corresponded with a another 4.5 level player who is 2 years out (leecrowley). Lee said it took him a full year before his stamina was good enough to return to his former level. Hope that helps.
 

leecrowley

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Messages
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Location
Tulsa, OK
Trying a new med combo...

Trying a new med combo...

Cday is right.....it took about a year to get back to my former playing level. But, I still struggle mightily with stamina. I can jog and bicycle almost as much as I want, but the quick-burst actions you need in high-level tennis just drain the heck out of me. In fact, I've given up on playing competitive singles. I just get too tired after 4 or 5 games. I strictly play doubles now, which is fine because that's what I am better at anyway. I can usually play doubles for a couple of hours with minimal problems with stamina.

Just an observation here..........I've noticed over the past 6 months that the heat of summer does have an effect. My stamina was less in June and especially July, than it was in March and April.

I just had my 2-yr post-op follow up with my surgeon in Dallas yesterday. He suggested we try a different medication combo to try to help my stamina problems. Instead of 25mg of Toprol XL, two times per day, we going to slowly move toward one dose of the Toprol XL in the a.m. and a small dose of Lisinopril in the afternoon. Lisinopril is an ACE Inhibitor that I tolerated well before my surgery. If this new combo keeps my blood pressure in check, we'll go with that for a while and see if it helps. I'll know in about a month.

Good luck, and don't give up.

Lee
 
A

Alex

Susan, Cday, Lee,

Thanks a lot ! I havent had my minerals checked but I will do that. I also think it is true that heat has an effect, the first bad episode while playing tennis happened on a very hot day and later that same day I passed out with an arrythmia one more time just inside a store that had no A/C. I will make sure I drink a lot of electrolytes and gatorade-like stuff.

I also think I may need to warm up a LONG time for tennis..and I am talking about not just 5 minutes but maybe 15 min or evn more...my episodes while playing tennis seem to happen quite early but my concern is that it is just a few strokes and I start getting very tired and arrythmic...I hit hard and have a very long swing ( used to be a 5.5 player) but I cant still undertand how weak I am on a tennis court and how much my level is down ( if I try to get the proper footwork then it is even worse). Anyhow, I will stay optimist...thanks so much for your advise !
 

cday

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May 31, 2008
Messages
122
Location
Tyler, Texas
Great points

Great points

the quick-burst actions you need in high-level tennis just drain the heck out of me.

the heat of summer does have an effect. My stamina was less in June and especially July, than it was in March and April.

we going to slowly move toward one dose of the Toprol XL in the a.m. and a small dose of Lisinopril in the afternoon.

Lee
Alex - Hope your issues can be resolved and you can at least play doubles! (no offense doubles specialists)

Lee - Thanks for the reminder that the type of activity required for tennis is very different from most other sports that people return to post-op. I needed that reminder. And I'm sure the HEAT FACTOR is very significant.

I am very interested in hearing your experience with the change in meds -- let me know. My husband (like Alex) is on Carvedilol and is trying to find a level that will give him energy and not cause fluid retention. He played some 4.5 doubles last week and did OK -- he let many a ball go by that he would have hustled to before -- but it sounds like you are saying that is the new "normal".

Did either of you have high blood pressure before AVR? What is it on the meds?
 

ponygirlmom

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May 2, 2008
Messages
660
Location
Fountain Hills, Arizona
I consulted with my husband, a former 5.0 player. He says that the combination of sprinting, jumping and stretching that you do while playing at a high level is much more demanding on your heart than any running or biking.

A few months ago, when you were having less problems, you were not only able to do less while playing (fewer months out of surgery) but you were taking a lower dose of beta blocker.

He says the beta blocker is not helping you in this situation; it's hurting you. Your body is getting deprived of oxygen.
 
S

Susan BAV

Speaking of oxygen, when it's hot and humid there is less available oxygen in the air.

It's a significant enough difference that a private pilot in a small plane flying on a hot day at 9500 feet would have to closely keep track of his density altitude measurement on his altimeter (sea level pressure corrected for temperature) because there could be a lot less oxygen, even a couple of thousand feet difference, and he would very likely need to put on his supplemental oxygen canula.
 

leecrowley

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Apr 25, 2006
Messages
40
Location
Tulsa, OK
Alex-
Have you talked with your Cardiologist or surgeon about your stamina problems? After telling my surgeon how important it was for me to continue playing competitive tennis, he said he would be more proactive with me in making medication adjustments to help. He also mentioned that being two years post-op was an important time threshold to pass in his opinion......regarding medication adjustments. He is adamant about his Ross Procedure patients taking a beta blocker to increase the longevity of the valves. But, he told me that being past two years post-op with no heart problems was important, and he was more willing to try new things with the meds.

Let your doctor know that this is very important to you, and see if they'll work with you more. Maybe they will, but not for a few more months. Hang in there.

Cday-
Chris is only a few months post-op. Tell him that it will get better. It may not get back to what it was in his prime, but it will be better than what it is now.

Before my surgery my B.P. was pretty high......145/65. I started taking Lisinopril (20mg) about 18 months before surgery, and that got it down to 135/60.

For the first year post-op, I was on Toprol XL at 50mg 2X per day, and my B.P. was usually about 110/65 with a resting pulse around 55. For the past year, my dose has been 25mg 2X per day, and my B.P. has been around 118/70 with a resting pulse near 60.

We'll see what the new meds combo does. I played last night for well over 2 hours, but I got pretty ragged by the end....nothing new there. I'm not playing again for about 10 days. By then I'll have several days with my new meds, and should have a good idea on their effects. I'll let you know.

Lee
 
A

Alex

Hi all,

Yes, I have told my cardiologist how important this is for me. I am wearing a monitor ( now for a month) while trying to play...yesterday I hit a few balls against the wall and my heart rate was at 170+ very very quickly and I got very tired and feel like my upper stomach was burning/pressing me. I sent the recordings from the monitor to the hospital and my cardio looked at them ( apparently lots of PVCs while hitting) so he has now increased even more my dose of Carvedilol ( I think I am at the maximum dose now of 25mg X2 of Coreg). This is crazy...I hate to see how as time go by instead of taking less medicine I have to take more...it is true that I am not fainting any more but I feel pretty burnt when hitting and before i didnt. My family dont believe me but I am pretty sure something is wrong...I should feel better not worse.

Thanks to all, you are all great !
 

cday

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May 31, 2008
Messages
122
Location
Tyler, Texas
Alex,

Just noticed that you said you had a AV Repair not Replacement -- what does that mean?
 
A

Alex

Cday,

I had a bicuspid aortic valve and severe aortic regurgitation, my left ventricle was getting enlarged and a bit tired. They told me they'd open me and if they think they could fix the valve they would do it, otherwise it'd be replaced. Looks like the valve was a good candidate to last for many years with a repair so that is what they did. It still leaks a bit but apparently is trivial, is very marginal. I had a dacron replaced part of my aorta and my aortic root reshaped. The procedure is the modified Tirone David ( I think they call it Tirone David II).

Regards,

Alex
 

cday

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Messages
122
Location
Tyler, Texas
Alex,

How do they "fix" a BAV? Since BAV are prone to two problems - stenosis and sclerosis only one of which seems fixable I would guess that where able to remove some of the stenosis and that you didn't have much sclerosis. So, how often do they check the repaired valve?

Your symptoms seem like the kind that would warrant a call to the cardio and some answers as to what would be causing these -- are they MED related or VALVE related? Make a pest of yourself until you get it RESOLVED!
 
A

Alex

By remodelling the root, I dont know the tecnical details, it can only done in some cases when the valve is still in decent shape. You can do a search on-line for "tirone david procedure" or "bicuspid aortic valve repair", many suregeons dont do it but some do and, like Stanford or Cleveland, are getting very good results. they will check my valve now once a year as it appears that its doing its job well ( there is a very small leak but that is normal).
 

cday

Well-known member
Joined
May 31, 2008
Messages
122
Location
Tyler, Texas
Interesting. My husband still has a small leak too (after AVR). I hope that you will find the solution to correct your exercise related problems. Let us know.
 

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