Pain during strenuous exercise

After a few issues with upper limits since pacemaker install late March this year, l was finally on the improve. I had to get my cardiologist to up my limit because the 110 they had me set on was ridiculously low for pretty fit 52YO and was going into 2:1 block when I exercised. Now set for 170 and has been good while walking getting up to 140 at times. Now today I got back to my horseriding began to experience pain in the centre of my chest and in back  of my right shoulder. When I walk horse this goes away but started to work harder again and my heart rate climbs to 160s pain comes back then goes away again when I go slower. I tried this 6 times all for same result. The pain is centred on the sternum at around bra level and behind shoulder at pacemaker level and is quite uncomfortably strong and scary.As soon as I reduce the effort the pain goes away. No movement sensing is enabled. Is this pain caused by getting close to maximum limit? I know that the plumbing side of my heart is good cause I've had an angiogram to rule out chest pain 6 weeks ago when they had the limit set too low. Was so looking forward to getting back into my competitive horse riding again and now I'm wondering if it will ever be possible. Do I try to power past the pain, is there something wrong?Does anyone have any advice? I find that my cardiologist doesn't impart much information and I learn more from this forum than from him. Any help greatly appreciated as I'm feeling very uncertain again and not sure what to do.


3 Comments

riding

by Tracey_E - 2017-06-16 11:27:12

If your upper limit is 170, you'll want to try to stay below 160-165 so there is always a cushion. If you are hitting the upper limit, they'll be able to tell when they interrogate. I never had chest pain when I hit the upper limit but we are all different. For me, it was like hitting a wall, suddenly short of breath and very dizzy to the point of feeling like I was going to pass out. I had to learn to not push that hard. When that was not working, I went on a low dose beta blocker to keep my rate down. Then when I got my last pacer, they gave me one that goes to 220 so now my upper limit is 190 and I went off the bb's. That extra 20 bpm made a huge difference for me. 

Could it just be that you are using muscles you haven't used in a while? We heal and things get better, but as we get back to activity things are going to pull on that fresh scar tissue. I back off, ice, then try it again in a few days. Within 3-4 months, I was back to doing everything I did before. 

First thing to do is find out if you are still hitting the upper limit. If yes, then powering through is not the answer. If it's muscles and scar tissue, then yes, pushing through is the right thing to do, just do it in increments. 

It is perfectly normal to take a few tries to get the settings right! Or more than a few. Don't be shy about going back. Write down day/time that things happen. If you have a home monitor, hit the button to force a download after it happens. Most doctors don't have a lot of experience with active patients so it's not something they see often enough to get really good at it. Settings are not one size fits all so sometimes we stump them. A tool that helped a lot with my settings was a stress test. Get on the treadmill while on the pacing computer so they can see exactly what's going on, make changes, then test them out and then adjust again. I recently switched to a new ep and he does 24 hour holters on everyone. He said lifestyle and pacing history give him 80%, the holter gives him the last 20%. 

Don't give up!! The good news is once they get it right, you should be good to go indefinitely. 

Chest pain on exertion with a normal angiogram

by Selwyn - 2017-06-17 12:03:38

Unfortunately anginal chest pain may occur given a normal tredmill test or a normal angiogram.  The so called, Cardiac Syndrome X. 

Your chest pain certainly sounds like angina pectoris. Yes, it could be muscular. 

I would be tempted to have a trial of glyceryl trinitrate ( spray) and see if that gets rid of the problem. If so, chances are you have angina of effort with a normal angiogram. 

You need to discuss with a cardiologist the possibility of Cardiac Syndrome X.

Best wishes,

Selwyn

 

 

 

Pain during strenuous exercise

by Jacquelyn125 - 2017-06-20 08:04:03

Why don't you get a physiotherapy treatment?

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