Dizzy

Hello all
Firstly, I apologize for constantly repeating the same intro over and over again, but I think it is important to always set the table before serving the soup.
I am a 59 year-old physically active male who received a dual lead Sorin Rely PM at the end of May 2010 following a syncope. The diagnosis was Sick Sinus Syndrome, although I had been followed for a few years for bradycardia and type 2 AV block.
I am not taking any drugs related to those conditions, only Crestor and Monopril for cholesterol and high blood pressure respectively.
I am a competitive swimmer and have no problem doing 1,500 meters freestyle in 26 1/2 minutes - pretty good for someone my age. I think that I hydrate adequately during my workouts.
I have been doing fine - really well since the operation.
Over the last couple of weeks, however, I have had episodes of severe shortness of breath under inappropriate circumstances.
As a general rule, it happens after I've had a vigorous workout in the pool. I'll do perhaps 3 km and push myself. Then I'll sit in the sauna for some 10 minutes, followed by a relaxing shower. I take my time to dress, then take a brisk +/- 1 km walk to a major mall where I'll have coffee. It's during that walk that it hits me. All of a sudden, I'll feel as if my heart is beating out of my chest, I'll feel dizzy and my extremities start tingling as if I'm about to suffer a syncope. I occasionally have to lean on the wall to recover. A couple of minutes later, I'm fine.
This is a new development even though nothing has changed in my routine which I've been following for several years.
Of course, I'm keeping a low profile from my wife who will certainly not react well if she hears about this.
Does anyone have ideas and/or suggestions?
Thanks
Edouard

5 Comments

One swimmer to another

by Selwyn - 2011-01-28 06:01:54

Hi Edouard,
I am impressed with your swimming rate, I 've never been able to go that fast even before my pacemaker.
I think you are right over the syncope. Why? Either your blood pressure is dropping too much ( exercise and heat + medication will lower your blood pressure once you stop) and your heart is trying to keep up, or you have an arrhythmia.
I have an event recorder for looking at the ECG: after exercise I find the increased heart rate lasts for about 2 hours- during this time I am not being paced ( that is if at present I don't have atrial flutter!). I have found that vigorous exercise will precipitate cardiac arrhythmias ( and there is a death rate associated with exercise!)- recently noticed my flutter after dancing ( 140 beats per minute - irregular).
I would definately be seeking cardiological help with your story and take it seriously! You may find that you need to cut down ( I have taken it a little easier with exercise now I have flutter- on betablockers and waiting a cardioversion), like me you do the same exercise week by week, however we forget our bodies do age. SEE A CARDIOLOGIST PLEASE SOONER RATHER THAN TOO LATE.
Kind regards,
Selwyn

I agree

by ElectricFrank - 2011-01-29 01:01:08

There seems to be a tendency among well conditioned athletic types to keep on pushing even in the face of potentially serious cardiac dynamics. Near syncope is almost always caused by a large drop in blood pressure which deprives the body of oxygen. To have it happen at a time (such as post workout) when we are already in an oxygen deficit situation just makes matters worse.

Until you get the situation sorted out I would sure cut back at least enough to avoid the symptoms. Don't wait until nature cures the problem with a fatal arrest.

frank

Another Swimmer

by richan - 2011-01-29 06:01:38

Hi Edouard,
I have been involved with our local masters swimming program since the early 1970's. Before I got my PM, I was able to keep up with my lane mates. Post PM I have moved myself into a slower lane where there are 2 or 3 swimmers in front of me. I'm OK with chasing them (I'm old enough to be their old man - 72 this coming June). Some times, on a good day I can catch them towards the end of our work-out session. I think these kids actually get tired - I do have some stamina. As I understand it, after a good work-out there is a natural drop in BP. Because of vaso-vegal syncope that seems to happen shortly after workouts, I have had to cut back on caffeine and I have had to drink lots of electrolytes before, during, and after workouts. I do get an occasional brown-out but nothing like before.
Regarding swimming, I can't do 100's on the 1:30 anymore. I can do(on a good day) 4 on the 1:35; much more comfortable doing them on the 1:40 or slower.
I'm just pleased to be able to swim with this group.
My cardiologist has be on Midodrine to keep my BP from bottoming out. Seems to work.
Hang in there,

Richan

Thanks

by Edouard - 2011-01-29 11:01:10

Thank you all for your comments.
You've scared the heck out of me and I will be calling my cardio on Monday.
Ironically, I was signed up for a competition today and couldn't really let the team down. I swam, but did not try to break any records. Given the fact that I didn't have much competition in my age group, I should still do OK.
Oh! and my wife who hasn't read the postings in the forum for a while, just happened to take a peek. I'm busted!
Best regards
Edouard

YOU NEED HELP

by donr - 2011-01-29 11:01:20

Edouard: You started out w/ bradycardia & a block. Now you are showing symptoms of tachycardia - high pulse rate. The PM can do nothing to stop that. The PM is an accelerator, not a brake pedal!

Getteth thy butt into the Cardio office ASAP!

You have a chronological 59 YO body w/ about a 70 YO heart problem.

The exercise is great, but it is PROBABLY time to stop PUSHING as hard.

Is is cold where you live? If so, going for a brisk walk on the way to coffee could be causing the problems.

Get off the coffee!!! Caffeine is not a friend of hearts. Especially ones that already have arrhythmia problems.

Getting a PM is indeed a life style altering event. It's one thing to host a PM & take the attitude that it goes where you go & does what you do, but there are limits! You can no longer climb the TV 5 tower & hug the output antenna. Kick boxing as a hobby is kinda iffy. I took mine on a 18 mi hike w/ a bunch of 18 YO kids w/i a Yr of getting it. At night & over rocky roads & rough terrain. There are limits. Sounds like your PM & heart are sending you a message. You don't want to get the message "We quit!"

Don

Don

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