# High HR, Unusually Hard-Beating Heart on Exercise



## Hastings (Sep 18, 2008)

Hi. Quick question, if you don't mind.

I consider myself healthy. I've recently been tested and cleared of everything from diabetes to heart disease. I'm 21. I am 5'11 and 130 pounds. I have what is described as a runner's body, virtually no body fat. My biggest issue is an allergy that often severely impacts my ability to breathe through my nose without medication.

That being said, I don't get as much exercise as I should. In fact, I get very little now that my gym membership has recently expired. 

As of the last month or two (since going to the gym), *I have noticed my heart rate is 170-180+ when exercising to any moderate degree*. Often, if it continues, to the point of *DIB* and a visible (through a thin shirt), *pounding heartbeat* that progresses into *angina*. Upon ceasing the activity, it also takes a significant amount of time for my heart rate to return back to normal. I will even feel my heart start beating especially hard in my chest even after spending a bit of time sitting in front of the TV or the computer. Often, I don't feel like I'm getting enough oxygen and that I need to make a conscious attempt to breathe (weird description for a weird problem).

I don't drink coffee, alcohol, smoke, take drugs. Blood tests show no underlying issues (of what can be found in blood tests). I've never had a stress test/EKG (besides fooling around with one in Paramedic school). Family history of diabetes, heart attack, and stroke. Low Cholesterol levels. Allegra-D for allergies (feel like at-rest beating heart began with start of medication). *Resting heart rate of 74 average. Blood pressure at rest is 120/80.* Medically cleared of any breathing issues beyond allergy. *170+ heart rate occurs with as little as casual walk with dog.*

I used to joke with my brother about taking the treadmills closest to the AED and the importance of keeping his hands near my chest, but it is something that really bothers me. I try to tell myself that my heart will become stronger with exercise and this wont be a problem, but is it possible there is an underlying problem?

I know none of us here are doctors, and nothing can take the place of definitive tests, but friendly opinions are encouraged and appreciated. Thanks.


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## LucidResq (Sep 18, 2008)

Sorry to hear you're having this problem. It must be pretty scary. 

It sounds like you're really thin. Are you eating enough? I know that, personally, when I haven't eaten for a while my heart rate will shoot up at the mildest of exertion. This also happens when I'm very sleep deprived. 

You probably realize this but it sounds like you should see a doc. Maybe talk to your GP and ask for a referral to a cardiologist if necessary.


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## mikie (Sep 18, 2008)

not to steal your thunder, but I am similar.  Though I'm 5'7 (short B)) 180, so a lot heftier (more to love!), resting bp of 124/80ish, resting pusle anywhere between 72-88 and when I work out, my pulse rockets to 170+.  I too feel the pain, just not as much as the OP described.


OP, have you had any cardio-related tests run?  Stress-test? XII?


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## rchristi (Sep 18, 2008)

QUOTE"I know none of us here are doctors, and nothing can take the place of definitive tests, but friendly opinions are encouraged and appreciated. Thanks."

That is right. More than a few world class athletes have died from undiagnosed heart conditions. You can't wish away a problem if one exists.
My advice is go find a Doctor, tell him your history and follow his advice as to follow up. End of sermon


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## VentMedic (Sep 18, 2008)

Hastings said:


> I consider myself healthy. I've recently been tested and cleared of everything from diabetes to heart disease. I'm 21. I am 5'11 and 130 pounds. I have what is described as a runner's body, virtually no body fat. My biggest issue is an allergy that often severely impacts my ability to breathe *through my nose without medication.*


 
Allegra-D? It has pseudoephedrine.

Look up the side effects on its website. 

Any OTC nasal spray? That can have side effects also. 

If prescribed by a doctor, does he/she know about these symptoms?

You mentioned all of your labs but what was your fitness level prior to now? Marathon runner? 

What is your diet mix for fuel? Carbs? Proteins? Fats? 

You can also check out your target HR for your age.
http://www.americanheart.org/presenter.jhtml?identifier=4736

At a 100% target HR, you would be about 200. Not advisable since your are symptomatic at 170 which is about 85%. You may need to drop your excercise intensity to reach a target HR of 50% to condition your body to whatever workout you are doing now and then gradually advance. 

Other factors would include your VO2 max ability with impaired breathing from your allergies.

However, without knowing you, it is difficult to give any advice other than see your doctor.


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## MJordan2121 (Sep 18, 2008)

I totally understand. I am 5' 10 and 126lbs. My resting BP is usually 120/80, barely a notch or two over/under at any point and resting HR is about 60-64. After doing moderate to heavy exercise for about 15-30 minutes, my HR is usually around 180-195, but several minutes after resting and cool-downs, my HR returns around 60-64 again.


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## Hastings (Sep 19, 2008)

VentMedic said:


> Allegra-D? It has pseudoephedrine.



Thanks for the comments and opinions everyone. Saw a professional about it. Turns out you were right on Vent. It's a matter of sensitivity to the medication resulting in the cardiac symptoms. I've been off the medication for two days now, and I haven't felt any of those symptoms since.


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## LucidResq (Sep 19, 2008)

VentMedic said:


> Allegra-D? It has pseudoephedrine.



Wow I didn't realize that. I hate that stuff. I also had a sensitivity to it which resulted in hallucinations and other adverse effects after taking just the recommended dose.


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## VentMedic (Sep 19, 2008)

Let me take the opportunity to toss in my pitch for more education in EMS.   Knowing the active ingredients, what category they fall into and what systems they stimulate are things that will be found indepth in college level pharmacology classes.   The "note cards" in EMT or Paramedic school rarely provide enough information to understand reaction and interaction.


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## Hastings (Sep 19, 2008)

VentMedic said:


> Let me take the opportunity to toss in my pitch for more education in EMS.   Knowing the active ingredients, what category they fall into and what systems they stimulate are things that will be found indepth in college level pharmacology classes.   The "note cards" in EMT or Paramedic school rarely provide enough information to understand reaction and interaction.



You're right. My Pharmacology class in Paramedic school taught us to many common home medications along with the drugs we would have access to for treatment - names, doses, indications, contraindications, interactions, reactions, and ensured we knew every potential effect of the drugs; primary and side-effects - however, they obviously could not teach us all. Since then, I've been learning as I go, often doing internet searches on Wikipedia on medications I encounter in patients' homes. And really, it's not an issue of education. There are too many drugs out there. They can teach you common medications, but in the end, all you can do is learn as you go and take that extra step to seek information on the drugs you aren't familiar with when you can. Unfortunately, I didn't do my proper research this time around. 

After you made the initial suggestion, I looked it up, and had a whole new understanding about how nasal decongestants of that type work. In short, sympathetic stimulation, leading to vasoconstriction (the primary effect), decreased inflammation, and in the end, a larger passage. However, along with that, other cardiac side-effects that are to be expected with sympathomimetics: tachycardia, palpitations, anxiety, excitability.

Again, learning as I go. But I'll tell you, now, if I have a patient on Allegra-D or other similar medications with pseudoephedrine that is experiencing unusual cardiac or neurological symptoms, I'm going to have an extra question or two for them. It's such a simple explanation now that I have more knowledge of the medication's systemic actions. Truth be told, on a more personal level, I should have known the ingredients and side-effects before I began taking it. Lesson learned. Two lessons, actually. Thanks again Vent.


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## VentMedic (Sep 19, 2008)

I found out the hard way also with a scary episode of palpitations and a little tachycardia from Sudafed, when it still contained Pseudoephedrine, and second hand albuterol exposure.  

BTW, all the inhalers (MDIs) have undergone changes with new meds, formulations and new rules.


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## mycrofft (Sep 23, 2008)

*I was going to ask how your mitral valve was....*

Keep a pharmacist on speedial. They are used to being treated like Pharmaceutical Pez dispensers and often will knock themselves out to give you fast correct and thorough information if you treat them as colleagues or better.


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