Major Decision

I don't know what to do. I have had problems with chest pain and shortness of breath with exertion since July 2010. I have had the full spectrum of cardiology and pulmonary function tests. Everything is normal except in 4 different stress tests from Sept 2010 to last week, my maximum heart rate during exercise is significantly decreased. All the doctors have called it chronotropic incompetence. One group of docs told me it is just due to my deconditioning as I have been unable to exercise for months. They told me to exert myself for 8 weeks and everything will return to normal. The other doc says it is time for a PM. Who do I believe?

6 Comments

What I would do.

by biker72 - 2011-01-20 01:01:28

Given your symptoms, I'd find SOME way to exercise for 8 weeks.

If that doesn’t work then it's PM time.

PM last resort.

by Skyking - 2011-01-20 04:01:13

I would have to listen to the docs when they say exercise for 8 weeks. The alternative is a ICD/PM ? The decision looks pretty clear to me, I'd start exercising pronto

Major decision

by Smooth - 2011-01-20 04:01:40

I too had problems with chest pain and labored breathing especially when walking uphill. I was in good shape for my age and stress tests as well as a catherization showed no problems however one of my doctors felt a pacemaker was the way to go as he felt the heart electrical system was the problem. It did the trick and I have had only one problem with it since and a minor adjustment corrected the problem. I have a Medtronic 3 wire. Age should have nothing to do with whether you need a PM or not.

I take it

by walkerd - 2011-01-20 06:01:49

you dont have a pm now right? This situation is a strange one to say the least, a group of doctors say your ok and 1 says you need a pm???????? If your tests are negitive then I wouldnt worry alot and try what the group of doctors say, Im taking it the group of doctors are the ones that preformed the tests? Ive never incountered this situation as tests are sent to my Cardio doctor and ussaully he either talks to me or referrs me to another specialist to the problem if one turns up.
I would ask the one doctor why he says you need a pm when others havent told you that you need one and have told you to workout for eight weeks and get him to answer why he thinks you need one. Then proceed from there.
good luck
dave

Top Doc

by Firefoy - 2011-01-20 10:01:53

The doc that says I need the PM discussed my case with Dr. Cannom. Dr. Cannom is supposed to be the best EP in the state. He agreed with the PM. The other docs at Cedars are saying no PM becuase I am only 40 years old.

Id run

by walkerd - 2011-01-21 06:01:39

from the docs saying because your just 40 years old you dont need a pm. Id go with the your main doc and Dr. Cannom. Saying you are to young for a pm is absurd. There must be something they have seen with your heart from the studies that warrant them to say you need a PM, Id ask and get answers first also. They should commidate you on your request for some answers, be firm to get answers that affect your health if not given answers to questions, have them explain in laymens terms so you understand. Good luck Firefoy keep us updated, prayers are with ya.

dave

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