Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Pounding Heart Beats And Fatigue Post Exercise?
Question: I am an active almost 70 year old woman with a history of PVC. I am wondering about a new symptom: a strong regular heartbeat that fades to a regular but almost impossible to feel heartbeat. Recently, after vigorous exercise, jogging up inclines for 30 minutes, about one hour later, I felt such EXTREME FATIGUE that I considered having my husband come get me as I did not know if I could drive home. I did drive home but felt so ill that I went to bed. After 8 hours, I felt fine. This is worrisome to me. My doctor says I have a healthy heart since I can ride 5 miles standing up on my bicycle which I do several times a week.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello XXXX!
Welcome on HCM!
Regarding your concern, I would explain that when dealing with strong heartbeats it is important to rule in/out a possible pathological tachycardia (supra-ventricular or ventricular).
This would be highly suspected especially in your case with a history of known PVC.
You should know that arrhythmic events may be present even in a structurally normal heart like yours.
It is very important that your cardiac function and structures have resulted normal, as in such case possible arrhythmic events would not be considered dangerous.
Nevertheless, I would recommend performing an ambulatory 24 to 48 hours ECG monitoring for investigating possible complex arrhythmic events.
Also, some additional tests like:
- thyroid function tests,
- blood electrolytes level,
- complete blood count (excluding a possible anemia),
- exercise cardiac stress test (to reproduce the situation of physical exertion when those symptoms occurred),
- cardiac ultrasound (if it is not already performed),
would be helpful in identifying any possible arrhythmia triggering factors.
You should discuss with your doctor on the above mentioned issues.
Hope you will find my answer helpful!
In case of any further uncertainties, feel free to ask me again.
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello XXXX!
Welcome on HCM!
Regarding your concern, I would explain that when dealing with strong heartbeats it is important to rule in/out a possible pathological tachycardia (supra-ventricular or ventricular).
This would be highly suspected especially in your case with a history of known PVC.
You should know that arrhythmic events may be present even in a structurally normal heart like yours.
It is very important that your cardiac function and structures have resulted normal, as in such case possible arrhythmic events would not be considered dangerous.
Nevertheless, I would recommend performing an ambulatory 24 to 48 hours ECG monitoring for investigating possible complex arrhythmic events.
Also, some additional tests like:
- thyroid function tests,
- blood electrolytes level,
- complete blood count (excluding a possible anemia),
- exercise cardiac stress test (to reproduce the situation of physical exertion when those symptoms occurred),
- cardiac ultrasound (if it is not already performed),
would be helpful in identifying any possible arrhythmia triggering factors.
You should discuss with your doctor on the above mentioned issues.
Hope you will find my answer helpful!
In case of any further uncertainties, feel free to ask me again.
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much. I have an appointment with my GP this Friday and will take your response to him. I forgot to mention, in case it would be helpful, that I have never smoked, drink perhaps 3 drinks per month, have always had low blood pressure and have always had normal blood work including my iron, and lipids.
Brief Answer:
Opinion as follows:
Detailed Answer:
Hi again, dear XXXXXXX
It seems that you have no obvious coronary risk factors (no hypertension, no smoking, no high blood lipids, etc.).
As you have usually low blood pressure, it is important to exude an orthostatic hypotension or orthostatic intolerance, which could be a potential reason for your symptomatology (strong heartbeats, extreme fatigue, etc.).
If your blood pressure drops at least 20 mmHg (systolic) or 10 mmHg (diastolic) when assuming the upright position form sitting position, then orthostatic intolerance may be the reason.
In such case, a head Up Tilt testing would be advisable to definitely confirm such a disorder.
Just discuss with your attending doctor about this possible reason.
Regards,
Dr. Iliri
Opinion as follows:
Detailed Answer:
Hi again, dear XXXXXXX
It seems that you have no obvious coronary risk factors (no hypertension, no smoking, no high blood lipids, etc.).
As you have usually low blood pressure, it is important to exude an orthostatic hypotension or orthostatic intolerance, which could be a potential reason for your symptomatology (strong heartbeats, extreme fatigue, etc.).
If your blood pressure drops at least 20 mmHg (systolic) or 10 mmHg (diastolic) when assuming the upright position form sitting position, then orthostatic intolerance may be the reason.
In such case, a head Up Tilt testing would be advisable to definitely confirm such a disorder.
Just discuss with your attending doctor about this possible reason.
Regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much. I have an appointment with my GP this Friday and will take your response to him. I forgot to mention, in case it would be helpful, that I have never smoked, drink perhaps 3 drinks per month, have always had low blood pressure and have always had normal blood work including my iron, and lipids.
Brief Answer:
My answer as follows:
Detailed Answer:
Dear XXXXXXX
As I already explained you before, you have no cardiac risk factors. The fact that you drink sometimes, it is not a risk factor (drinking 100mg alcohol per day would be a risk factor).
So I would advise you to discuss with your GP on the above mentioned tests.
You can ask me directly at any time at the link below if you have any other uncertainties:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765
Please keep me informed on your test results. I would be happy to review them for a second professional opinion.
Best wishes,
Dr. Iliri
My answer as follows:
Detailed Answer:
Dear XXXXXXX
As I already explained you before, you have no cardiac risk factors. The fact that you drink sometimes, it is not a risk factor (drinking 100mg alcohol per day would be a risk factor).
So I would advise you to discuss with your GP on the above mentioned tests.
You can ask me directly at any time at the link below if you have any other uncertainties:
http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765
Please keep me informed on your test results. I would be happy to review them for a second professional opinion.
Best wishes,
Dr. Iliri
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
