Is anyone like me? crossfit, bradycardia, dizziness, no other symptoms, ekg/echo/halter clear

Hi everyone,

I'm new here.

I'm hoping to find someone like me because I'm chasing my tail trying to get diagnosed.

45 yo female, 5'6", currently 212 lbs (thanks to weight gain from whatever is going on)

Have always had low HR (50s) even when heaviest (270+)

Started Crossfit almost three years ago.  Lost a ton of weight, toned up, got strong, felt fantastic.

Started with severe fatigue almost a year ago (June/July 2016).  Ended up diagnosed with early menopause.  Estrogen seemed to help at first, but fatigue would return.  Bumped estrogen up a couple of times over several months.  

Tests show estrogen and hormonal functions normal, thyroid normal, vitamin D normal, all CBC normal.

Was referred to cardiologist.  I thought "how could it be my heart?  I've been crossfitting and feeling great up until menopause"...   I have a grade 2 murmur, which is supposed to be no big deal.

They put me on stress test and I got to 9 mins, but pulled me off bc BP went up to like 220-240 over 100 something.  

I had been getting lightheaded coming off heavy squats or high volume squats (with weight), thrusters.  Leg-related stuff is the only place I get light-headed.  No other movements that I've noticed.

Outside of severe fatigue, that is my only other symptom.  I have not noticed feeling dizzy during normal routine.  I have recently noticed that going up stairs or walking at a fast pace can make me feel "winded" but not noticeably -- however more than they should.

My resting heart rate has gone as low as 38.  Sleeping it has gone down to 32.  My resting heart rate lately has been in the high 40's.

Some results from testing:

Halter.....
lowest awake BPM was 35
avg HR 57
Mx HR 111 (slow day)
rare premature beats
no concerning arrythmias

Echo....
good pump function
mild dilation L upper, R upper. Little larger bottom R too.
(indicative of sleep apnea, which may have been when I was heaviest, so doing a sleep study to make sure it's not a current issue.  remote possibility of central sleep apnea).
mild valvular leakage (heart mumur)

Doc had told me that if I had damaged my heart from repeated HBP during crossfit, my heart walls would be thickened and it would be reversible.  There was no evidence of this, thankfully.

Doc wanted me to keep BP less than 180/100 (neither could go above these numbers) when exercising.

Referred for sleep study.

And I'm going to make an appointment with an EP tomorrow because I cannot deal with this fatigue anymore.

Even when I was at my heaviest, you couldn't stop me all day.  The days I was tired back then were because I had 3 hours sleep and hadn't stopped.

Now, since I made a huge lifestyle change almost 3 yrs ago now, I work hard to get my 7-8 hours asleep (as best I can, almost always), eat very well with the help of a nutritionist, crossfit regularly (althoug not lately because of fatigue).

My resting heart rate has gone down 10ish beats per minute in the past 18 or so months.  And I wonder is it because I'm more fit?  Or is something happening with my heart?  Or did menopause slow it down?

When I am severely fatigued, which is the majority of the time lately...  If I try to push myself because I think I'm being weak, it makes it even worse.  I feel like I'm flared up and extra exhausted.  So I've learned to just stop.  Even if it means hardly working out at all.  Which is killing me....

I miss crossfitting 5-6 days a week and doing competitions for fun with my friends so much.

I literally have no other symptoms.  I have never fainted.  No aches or pains (my body actually feels great despite not working out regularly).  No GI stuff.  Nothing...  

My head and shoulders just feel like lead.  

And then today...  For the first time, it felt like my eyes and brain weren't compensating for my movement.  When I walked next door to get a sandwich, not even 1/4 mi away, it was like watching someone with a shaky camera.  And I guessed it was because I've just been extra fatigued today.

I'm sorry this is so long...  I'm just throwing everything out there to see if anyone is like me.

I'm hoping to get a visit with the EP as soon as possible.

Thank you for any feedback in helping me try to figure out what is going on.


8 Comments

Questions to ask your EP

by Paced2017 - 2017-04-25 08:39:29

It's good that you're planning to get an EP opinion about your situation. It sounds like some common causes of a slow heart rate and fatigue have already been excluded (underactive thyroid gland, anaemia). You don't say how long your Holter was on for but short periods of time (1-4 days) may not be enough time to detect any arrythmias such as AF which may be contributing. As you say too much exercise could be contributing too, so if I was in your shoes I would be stopping this to see if your heart rates comes up over time (AF can also be induced by endurance exercise).

Your description of feeling like your eyes and brain aren't compensating for your movement is something I've experienced too and the pacemaker I had put in 8 weeks ago for sick sinus syndrome (SSS) seemed to improve this for a while, but in recent days the problem has returned. I switch between contact lenses and glasses and have noticed that this symptom is better when I wear my contact lenses, so it might be worth have an eye check too. I am much less fatigued than before.

If SSS turns out to be your diagnosis,remember that it is not a life-threatening condition and the only reason for you to consider a pacemaker is if your EP thinks that it's going to help your symptoms. Have a look at drjohnm.org for 4 crucial questions to ask your doctor (what are the odds this will help me, what are the downsides and potential harms, are there simpler/safer alternatives, what happens if I do nothing?),  These are good questions to ask whenever a medication, procedure or test is suggested. There are many people with SSS who lead long and healthy lives without a pacemaker, so it really is all about symptoms, and you're the only person who can make that judgement once other causes have been ruled out. Good luck with your EP!

Can't diagnose--but here's my story

by Gotrhythm - 2017-04-25 14:49:50

Not totally sure what youi are asking, I ceratinly can't diagnose you, but my story is similar to yours. At the time my need for a pacemaker was discovered, there was absolutely nothing wrong that showed up on any of the usual tests, including EKGs. BP 110/60. Blood work was excellant, my heart rate was 60 and my EKG was text book normal.

My only symptom was extreme fatigue, skipped beats, and shortness of breath when climbing stairs. But only sometimes. Occasionally, on the stairs, I felt close to passing out but I never did. Somedays I could climb the stairs with ease and I felt almost okay. Oh, and did I mention I felt rotten!--well, except sometimes when I thought maybe I was finally getting better? :-)

Becuase my heart was "okay, "but I complained of SOB, I was sent to a pulmonologist. By sheer luck he was listening to my chest at the very moment my heart took a swan dive. He ordered a Holter monitor. It showed my heart rate going down to 34 BPM, sometimes, with 4-6 second pauses.

I went through a lot of denial enabled by the fact that sometimes I appeared to be okay. I didn't understand how I could be healthy but need a pacaemaker. I wound up in an ER, watching the heart monitor. For the first time I could see the correlation between my heart rate and how I felt. When it was 60 BPM I felt okay--not great but okay. When it was 35 BPM, I felt terrible. 

Here's what you might need to know. You can be prefectly healthy but for some reason an otherwise healthy heart can begin to falter in its ability to beat fast enough. It's called Sick Sinus Syndrome. It can appear, totally independent of any heart disease. Both men and women can get it.  It can come on at any age but the older you get, the more common it is. There's no cure, but a pacemaker can allow you to live a normal life, and a normal life span.

If the EP recommends a pacemaker, you'll have lots of questions, so be sure to come back.

Similar symptoms

by TBrous&Chip - 2017-04-26 06:44:09

I had a hard time accepting my need gor a PM.  64 yrs old, no health issues, no medications, exercised,  normal weight but started passing out after bending over. 

After 6 months of testing with borderlibe results and still passing out my heart rate dropped to 39-42 and would not increase.  Rec'd PM and woke up from procedure feeling grest.

Thankfully no heart damage, just bad electrical signals.  The PM has allowed me to get back to a normal life..

This forum is a great place to go for info and support if you do need a PM

 

thoughts

by Tracey_E - 2017-04-26 18:20:05

Random thoughts in no particular order...

Talk to the ep and get the sleep study so you have the full picture. Right now is just speculation. They don't know why, but heart conditions and sleep apnea can go hand in hand so perhaps that is the root of the problem. 

Nearly everyone has premature beats and mild murmurs. They are unlikely to be causing the problems. 

A rate in the 30's, even if it's just during sleep, can make you tired. A resting rate in the 40's can wipe you out too. 

Many never pass out. The idea is to fix it before that happens! My rate dropped to the low 20's the day I was admitted to get my first pacer. I never passed out, even drove myself to the hospital (that did NOT go over well, do not try that at home lol). It was like being drunk and my brain definitely wasn't firing on all cylinders, but I did not pass out. 

Electrical cardiac problems can happen when we are healthy and active and take care of ourselves, when we have no other health issues, when our heart is otherwise perfectly normal. It's like a short circuit, the wiring breaks down and we have no idea why. Nothing we did caused it, nothing we could have done differently would have prevented it. 

Thyroid problems can cause heart rate to drop. Blood pressure medication will slow the heart as it drops blood pressure. 

Blood pressure is not related to heart rate, so there may be two things going on. 

Don't push yourself until you know what is going on. That's not weakness, that's caution. 

The good news is if they decide low heart rate is causing the problems, it's an easy fix. Many of us Crossfit after being paced. If you end up needing it, I'd be happy to talk to you about how they can place it so it doesn't get in the way when the bar is in front rack, pull ups, etc. I don't have any restrictions, go 5 days a week. I'm 50 now,  got my first pacer when I was 27. It's a tool to get our lives back, nothing more. Don't fear it. 

Thank you!

by oKristie - 2017-04-27 00:44:18

Thank you everyone for your feedback!  I was just hoping to hear that there may be someone else out there with similar symptoms.

This has been going on, and the fatigue getting generally worse, for almost a year now, to the point where I spend more time resting than being productive because I'm "listening to my body".  It used to be an extra rest day or two a week.  Now it's rest and get real work done as I can.  And then workout with anything that's left -- lately that's nothing. 

I completed the open and was really proud of how I did despite my fatigue.  But it's gotten worse and I haven't really worked out since the open.

I did get an appointment with an EP for Friday.  I have a sleep consultation tomorrow morning and hopefully a sleep study asap.

My body otherwise feels really great.  I'm just in a fairly constant state of what it feels like right before you get the flu.  Tired and a little bit of muscle burning/weakness.

Just so frustrated and really appreciate all your thoughtful replies!

I want to get back to fitness and feeling great.  It can't come soon enough.

I will keep you posted on the results of my consulation with the EP.  Thank you!

ticks

by marylandpm - 2017-04-27 19:07:43

 Don't rule out Lime.

Jack

Lyme Disease

by sgw2 - 2017-06-19 01:09:21

I was thinking the same thing. Talk to your doctor about a Lyme test and rule that out if they think it's a possibility. And remember that not everyone gets a bullseye.

thank you

by oKristie - 2017-07-31 19:29:20

Thank you everyone for encouraging me.

I completed all of my cardiac testing and my heart and lungs were excellent and above average.  My EP cannot come up with any good reason to simply put a pacemaker in me.

I continue to have awful fatigue, but I'm going back full circle to hormones since this all started when I was diagnosed with early menopause.  My primary care and regular gyn ruled it out, but I went back to the specialist I used in 2012 when I had a hysterectomy and cancer scare.  

She is fabulous and ordered a barrage of tests last week.  I feel like she is going to help me.

I just wanted to thank you all so much.  I really appreciate the time you spent to respond to me and the thoughtfulness of your posts.  I do wish you all the best!

Sincerely,
Kristie

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