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Cardio update
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Sparky
Joined: 08 Dec 2003
Posts: 16861
Location: Portland, OR

11/13/18 3:32 PM

Cardio update

Saw the Cardio Dr today. Two months to get an APPT with him. Was told he was worth the wait. Did not expect a Cardiologist to have excellent bed side manor after all the God complex I have heard from RNs etc among friends and family. Guy was great with the communications.

I was floored by the number of PVCs I had in 48 hours of the Holter Monitor. He said 20k outta a million is Benign.

Hearing the Cardio Dr. using the "B" word is more reassuring than the GP saying too.

Scheduled a Treadmill Stress test, and an Ultra sound of my heart.

I am excited about the Treadmill stress test. Always have wanted to see a very controlled max HR.

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dfcas
Joined: 11 Jan 2004
Posts: 2524
Location: hillbilly heaven

11/13/18 5:20 PM

When I did an treadmill stress test they shut me off at 80% of estimated max and calculate from there. I think they are afraid of people collapsing on the ,mill.

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Sparky
Joined: 08 Dec 2003
Posts: 16861
Location: Portland, OR

11/13/18 6:02 PM

yeah, he said the max would be 85% approx.

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dan emery
Joined: 11 Jan 2004
Posts: 6075
Location: Maine

11/13/18 6:23 PM

Benign is good

Glad to hear the cardio says benign. Is the ultrasound an echocardiogram? I've had a couple of those - the image is amazing.

When I took the treadmill they let me go as hard as I could, which was about 40 beats above the calculated "target rate." They said the harder I could go the better info they got. May be somewhat different consideration with a nuke test as I had, dunno. I think they just don't expect people to get much above the target rate. At one point they said "can you go another minute at this level?" and I said "I could go an hour like this."

I've seen quite a few good doctors and they've all been good guys.

I also just had a cardio check, everything seems OK, they said go to Antarctica, just take some extra meds.


Last edited by dan emery on 11/13/18 7:09 PM; edited 1 time in total

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Sparky
Joined: 08 Dec 2003
Posts: 16861
Location: Portland, OR

11/13/18 7:02 PM

ECG, yes.

"the harder I could go the better info they got"

I have to imagine not cases that are not afraid to run zone 4 for long periods is not something they get patient wise for this test in general.

I am going to watch "American Flyer" the night before. ;)

I'd much rather the Stress test was on a Tacx/Kickr/CycleOps etc than a tread mill.

I'd have said Computrainer, but even though I still have two, did not want to sound so dated, ;)

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KerryIrons
Joined: 12 Jan 2004
Posts: 2940
Location: Midland, MI

11/15/18 9:12 AM

Say hi


quote:
I am going to watch "American Flyer" the night before. ;)


Say "hi" to Eddy.

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Sparky
Joined: 08 Dec 2003
Posts: 16861
Location: Portland, OR

11/17/18 9:40 PM

Eddie!!!!

Aren't we gonna wait??

He'll catch us.... Here he comes..

That's Eddie? Son-nuva....

He ate my shoe!

___________

I seem to have a different HRM posturing riding since that visit. Quite a fast ride today, Wind and all...

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dan emery
Joined: 11 Jan 2004
Posts: 6075
Location: Maine

11/18/18 7:31 AM

Eddy or Eddie? Nm

Nm

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Sparky
Joined: 08 Dec 2003
Posts: 16861
Location: Portland, OR

11/18/18 11:00 AM

Now this even disturbs me I know this, too much google time...

Not my fav cycling movie by any means, but I'll take them all when I can get them. Breaking Away being my fav hands down. "He's shaving.... his legs...."


Eddy:




Dog=Eddie after Eddie Borysewicz, the coach.

Coach=pit bull get it? ;)

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Sparky
Joined: 08 Dec 2003
Posts: 16861
Location: Portland, OR

11/20/18 11:07 AM

Treadmill stress test today. Excited about it actually. ;)
Spoken like a true bike nut case? :)

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dan emery
Joined: 11 Jan 2004
Posts: 6075
Location: Maine

11/20/18 11:47 AM

Hope it goes well

I enjoyed mine.

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Sparky
Joined: 08 Dec 2003
Posts: 16861
Location: Portland, OR

11/20/18 2:40 PM

Well, besides these pesky PVCs, I am thinking never smoking and not drinking at all for over a decade now is paying off. ;) Maybe cycling even...

Estimated V02 Max=43.5 ml/kg/min.

This makes me a happy camper and motivated to loose weight. Considering my kg has 'room' to go down. If I can loose 25 lb this should be an even better number.

This is in the high percentile for my age apparently at my fat ars self. In the excellent column, very good mother nature, thanks. Of course they use norm stats, real athletes are higher, but I ain't one of those.

Peak HR 184 [had my HRM max set to 182]

One minute HR recovery 35 BPM.

Those are the figures she popped on a post it for me.

I'd like to do this test on a cycle, not sure it would actually matter results wise.

My right knee [06 ski tib/fib/plateau fractures] was not happy with the last ramp up [literately] and I decided to stop before that last 3 minute changed over to faster and steeper.

So two running ramp ups and I said OK/stop before the third. These after a few walking and one in between/trot?

Probably would not have changed much, but I am amazed that my Max HR at this age. 220 - my age is a joke.

But when I asked what actual % of the max HR the 184 is, she said 220-age, 184 is 115% of that. So being I was told they would only go the about 85% [possibly a little more if no issue] what that answer meant. I did not get to talk to the Dr. about it just yet.

I also never saw my BP at high HRs before. That seemed scary to me. But she nor the Dr was alarmed apparently. She left and showed it to him and came back.

It was fun though. Room could have been cooler, well later in the test.. ;) A fan woulda been nice.


Last edited by Sparky on 11/20/18 4:43 PM; edited 1 time in total

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Sparky
Joined: 08 Dec 2003
Posts: 16861
Location: Portland, OR

11/20/18 3:16 PM

Next week ultra sound, blood flow rate and valve function etc test.

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dan emery
Joined: 11 Jan 2004
Posts: 6075
Location: Maine

11/21/18 5:40 AM

Sounds good

Sounds like the ticker is tip-top.

Now lose that 25 lb (you said it, not me!)

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Brian Nystrom
Joined: 26 Jan 2004
Posts: 4189
Location: Nashua, NH

11/22/18 7:45 PM

220 minus your age is bunk...

...for many - if not most - people who are reasonably fit. At 61, my max is still 186 or better. Linda will be 70 in 4 months (ssshhh, you didn't hear that from me) and her max is in the mid 170s.

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KerryIrons
Joined: 12 Jan 2004
Posts: 2940
Location: Midland, MI

11/23/18 12:44 PM

Bunkum

Actually, given the never-stated criteria, it's quite accurate. What always gets left out is the standard deviation, which is something like 15 bpm. So 95% of people fall within +/- 30 bpm of the 220 - age prediction. Of course on an individual basis, the formula is totally useless.

Reminds me on an old joke about three statisticians going deer hunting. They spot a 10 point buck up on the ridge and take aim. The first statistician fires and his shot goes 15 feet in front of the buck. Amazingly, the buck just stands there so the second statistician's shot goes 15 feet behind the deer. The third statistician jumps to his feet and yells "We got him!"

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Brian Nystrom
Joined: 26 Jan 2004
Posts: 4189
Location: Nashua, NH

11/23/18 1:43 PM

Which really illustrates my point that "220 minus your ages" is worthless. What good is it if it can be expected to be as much as 30bpm high or low? I'd certainly hate to be someone on the low side of the curve!

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rickhardy
Joined: 11 Jan 2004
Posts: 1458
Location: Needham outside of Boston - the hub of the universe

11/27/18 9:19 AM

Brian good to see you at Shedd Park

Saw you at Linda's start but was busy working the race so couldn't say hello. Hope Linda enjoyed racing in the snow ...a first for Shedd and the 15 years we have run the race....

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Brian Nystrom
Joined: 26 Jan 2004
Posts: 4189
Location: Nashua, NH

11/28/18 8:29 AM

Yeah, she had a good time. Fortunately for everyone, it wasn't that cold so it wasn't icy, just a mucky mess in the "mud pit section", though even that wasn't as bad as in some past years. I shot a lot of pics back there and the snow added a bit of ambiance to the event.

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Sparky
Joined: 08 Dec 2003
Posts: 16861
Location: Portland, OR

12/7/18 4:44 PM

Echo test not terrible, but definitely less encouraging than the stress and est vo2 max etc.

Did not consult back with the doc yet.

Mild and border line used on a few of the results. But the one 'Moderate'; dilation of the aortic root, and mild dilation of ascending aorta sounds nasty when you say it out loud.

the borderline is referring to main chamber hypertrophy, concentric. Meaning the heart is not enlarged, but rather the chamber is smaller. 66% efficiency if that is what EF means?

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dan emery
Joined: 11 Jan 2004
Posts: 6075
Location: Maine

12/7/18 5:57 PM

Cardio stuff

I wouldn't try to interpret the stuff much until hearing from the doc.

I don't know about aortic root issues, but I have an aneurysm of the ascending aorta, which is probably worse than a dilation (they look at diameter, which I am not asking you to post). They tell me I have a less than 1% chance of a problem, and monitor it once a year to see if it's growing. So far it doesn't seem to be. When it was first diagnosed I thought about it all the time, now I don't really think about it other than I don't do heavy lifting or woodsplitting (which anecdotally can be problematic).

I think the doc will tell you that a 66% ejection fraction is fine.

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Sparky
Joined: 08 Dec 2003
Posts: 16861
Location: Portland, OR

12/7/18 6:49 PM

A normal heart's ejection fraction may be between 50 and 70 percent apparently...

Went to a party, and the friend that recommended this cardoi guy, his own cardio doc looked at the results. He is a anesthesiologist, made some comments regarding most folks my age heart is showing a lot worse signs in uncorrectible areas. ;)

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Sparky
Joined: 08 Dec 2003
Posts: 16861
Location: Portland, OR

12/12/18 4:45 PM

"I wouldn't try to interpret the stuff much until hearing from the doc."

Just got back.

"I don't know about aortic root issues, but I have an aneurysm of the ascending aorta, which is probably worse than a dilation (they look at diameter, which I am not asking you to post)."

Well, it is also an aneurysm. And diameter comes into play. in my case, just closer to the heart [root]. But thankfully not too close as to include a valve problem when too close. I suspect our issues are more alike than different. Any hypertension history for you? If that is not out of bounds question wise...

"They tell me I have a less than 1% chance of a problem, and monitor it once a year to see if it's growing."

"I don't do heavy lifting"

I was told not to lift over 100 lbs. My back already has that taken care of. I avoid over 60lb personally. I have the muscle power for it, but some lower back wear and tear from years of abuse... I am sure I am not alone. ;)

The boarder line Hypertension is an issue, I am on Beta blockers again as of today. Was on them when 38 years old for 6-7 months. With a 60lb weight loss and new cycling addiction at that time, I was off quick. Hoping for same result again, goal is to repeat hearing the Dr, say stop taking the Beta Blockers. ;)

Like you, I will be having a yearly look see to make sure the aneurysm does not progress. I have another thing that popped I am having an additional test for. Stay tuned.


Last edited by Sparky on 12/12/18 4:49 PM; edited 1 time in total

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Sparky
Joined: 08 Dec 2003
Posts: 16861
Location: Portland, OR

12/12/18 4:46 PM

BTW, I asked about [beyond lifting] things like a full on hard full watts sprint on the bike. This is out, but not something I do much anymore really.

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dan emery
Joined: 11 Jan 2004
Posts: 6075
Location: Maine

12/13/18 6:48 AM

BP etc

I have had a few high BP readings in doctor's offices (white coat syndrome?) but I've been taking bp at home for years and it's generally pretty good. I was never treated for it until I got the aneurysm diagnosis, when I was put on a low dose of metoprolol as a preventative measure. If you have an aneurysm I think the beta blocker is your friend.

As to something like sprinting on a bike, I think there is little info. It may depend on your blood pressure response to exercise, to an extent. Mine didn't seem to be bad in the nuke stress test. I saw that Cleveland Clinic has a sports cardiology lab where they will do all sorts of tests, but I don't think I'm at a level for that. I can probably get along without sprinting or FTP tests to be on the safe side.

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