Measuring blood pressure and heart rate

[audreyh1]

Glad you are being treated and are going to be OK.

But now you've scared me. About a year ago, I was going through a stressful period and felt like my heart was beating irregularly. The Dr. put me in a Holter harness (a portable EKG - electrodes all over my chest) for 24 hours and later did an echocardiogram. All was OK.

So I haven't worried about my heart since then, but last night I pulled out the Omron and took my BP four times in a row just because I happened to think of it. Each time the BP was different, but normal. However, my resting HR was always in the 80's. I wasn't going to worry about it, since I felt OK, but now I am worrying!

Amethyst

I find unless I sit quietly with the cuff on for 5 mins, my readings can be quite variable. If I sit quietly for 5 mins they are quite repeatable. FWIW.

 

[RonBoyd]

However, my resting HR was always in the 80's. I wasn't going to worry about it, since I felt OK, but now I am worrying!

A normal resting heart rate for adults ranges from 60 to 100 beats a minute.

Here is a Google search

 

[audreyh1]

DH has a "pre-beat" - the rare skipped or sort of "double" beat. It's actually just off rhythm. He can really feel it when it happens. Cutting out caffeine has eliminated the problem for him. It's been over 5 years.

When he was wearing a 24 hour heart monitor, he couldn't get it to happen until he did some extreme aerobics and then managed to get just one event, which he felt and noted. This at least confirmed the condition.

 

[audreyh1]

A normal resting heart rate for adults ranges from 60 to 100 beats a minute.

Here is a Google search

Unless you are a tall man, in which case 50s and even 40s may be normal.

 

[Alan]

Thanks everyone for your kind wishes and good advice. I really appreciate having this circle of internet pals.

Before seeing the doc today at 11:20 I had checked my BP twice. Normal, and no irregular heartbeat symbol.

The doc did an ekg which was normal and I have now got an appointment with a cardiologist for the 25th, although have been told that if it repeats before then to take myself to an ER.

Like you Ron, there were no symptoms apart from a little dizziness and the reason I noticed was, because of a wonky shoulder I have, I was doing some physio exercises on it while standing in front of the TV watching The White Queen. By the time I'd driven 5 miles to the ER and was checking in I was no longer light headed and was starting to feel like a fraud.

 

[REWahoo]

... there were no symptoms apart from a little dizziness and the reason I noticed was, because of a wonky shoulder I have, I was doing some physio exercises on it while standing in front of the TV watching The White Queen. By the time I'd driven 5 miles to the ER and was checking in I was no longer light headed and was starting to feel like a fraud.

When your heart is concerned, it's perfectly acceptable to feel a bit fraudulent. Glad to see you didn't pass this off as something insignificant and are getting it checked out.

 

[RonBoyd]

Like you Ron, there were no symptoms apart from a little dizziness and the reason I noticed was, because of a wonky shoulder I have, I was doing some physio exercises on it while standing in front of the TV watching The White Queen. By the time I'd driven 5 miles to the ER and was checking in I was no longer light headed and was starting to feel like a fraud.

Dizziness is a symptom of A. Fib. (if the heart beats too rapidly, it becomes inefficient as a pump, and blood supply to the brain becomes an issue.) I (non-medical opinion) would doubt the two are related in your case.

The usual anecdotal symptoms of heart failure don't apply to A. Fib. -- the left arm pain, etc. A. Fib. is an electrical problem rather than a organic breakdown issue.

And don't be fooled. In the beginning stages, it is normal for it to come and go. That is the time to "fix" it. Once it becomes "permanent" it is with you for life. (Well some swear surgery can cure it but I am skeptical.)

Yes, I am downplaying it a bit so as to calm your nerves (I wished someone had done the same for me) but do know that it is a serious issue. In any event, REWahoo is correct. Imagine how embarrassed you would be at your funeral for not speaking up.


EDIT: I forgot to mention that I have no physical limitations because of it (although contact sports are frowned upon because of the blood thinners). For example, I can run a mile without a problem and I can lift weights as much as I want.

 

[Alan]

When your heart is concerned, it's perfectly acceptable to feel a bit fraudulent. Glad to see you didn't pass this off as something insignificant and are getting it checked out.

Thanks. Once I had made the decision to wake my wife up and tell her, then there was no way I was not going to go to the ER. As I left I nonchalantly told her to go back to sleep and I'd update her in the morning. (she sent me a text 2 hours later asking what was going on so I guess I wasn't nonchalant enough)

 

[RonBoyd]

Thanks. Once I had made the decision to wake my wife up and tell her, then there was no way I was not going to go to the ER. As I left I nonchalantly told her to go back to sleep and I'd update her in the morning. (she sent me a text 2 hours later asking what was going on so I guess I wasn't nonchalant enough)

You do know that you should not have driven yourself if you suspected a heart problem, don't you? Oh, the embarrassment of waking up in the hospital... Best case scenario that is.

 

[Alan]

Dizziness is a symptom of A. Fib. (if the heart beats too rapidly, it becomes inefficient as a pump, and blood supply to the brain becomes an issue.) I (non-medical opinion) would doubt the two are related in your case.

The usual anecdotal symptoms of heart failure don't apply to A. Fib. -- the left arm pain, etc. A. Fib. is an electrical problem rather than a organic breakdown issue.

And don't be fooled. In the beginning stages, it is normal for it to come and go. That is the time to "fix" it. Once it becomes "permanent" it is with you for life. (Well some swear surgery can cure it but I am skeptical.)

Yes, I am downplaying it a bit so as to calm your nerves (I wished someone had done the same for me) but do know that it is a serious issue. In any event, REWahoo is correct. Imagine how embarrassed you would be at your funeral for not speaking up.


EDIT: I forgot to mention that I have no physical limitations because of it (although contact sports are frowned upon because of the blood thinners). For example, I can run a mile without a problem and I can lift weights as much as I want.

More good feedback - thanks Ron.

I didn't ask the doc today about exercise and he didn't mention it so I plan on continuing a reduced regime for the next 9 days until I see the cardio chappy. We had ridden 11 miles that morning on our bikes but I didn't feel any after effects at all. Both the ER doc and my GP talked about the risks of clots and probable medication that I would be prescribed but neither gave me a prescription just yet. (I had the injection and was given an aspirin)


I think I'll take an aspirin a day until my appointment - can't hurt.

 

[Walt34]

Welcome to the Afib club Alan. Doesn't that make you feel better?

I've had a couple more events of it aside from the first. In the first I was having shortness of breath, rapid HR, and since I had a stethoscope by then I could tell from the sound of the heart that this was NOT a normal heartbeat. DW drove me to the ER and they did a cardioversion (electric shock) and sent me home ~45 minutes later. I got a mild rebuke for having DW drive me instead of calling an ambulance even though the latter takes more time. I asked if I could take some of the drug they gave me home and they just laughed. The drug put me to sleep in less than five minutes. They said it was in the same class as what Michael Jackson was taking and that no sane doc would use that as a sleep aid. Anyway....

The second time I could feel it - same symptoms - and when I was putting on a shirt to go to the ER it just reverted back to normal rhythm by itself. I let the doc's office know about it but they never called back so I guess that's a "normal" event.

ronboyd is correct. From what I've read about it and talked with the docs about it the threat is not from the Afib. Hardly anyone dies from that. The big threat is from stroke caused by the Afib - blood pools in the upper ventricles some of it may clot because it isn't moving through the heart. When the clot breaks loose it causes a blockage whenever it comes upon a restriction that it cannot pass through.

Needless to say I am very careful to take the prescribed meds on schedule and am almost fanatic about the gym routine and schedule. Never thought I'd be a gym rat but when the incentive is powerful enough....

BTW, I took a copy of the gym workout and BP/HR readings to the cardiologist and he was almost astonished - "Nobody ever does that!" was his comment.

 

[Alan]

You do know that you should not have driven yourself if you suspected a heart problem, don't you? Oh, the embarrassment of waking up in the hospital... Best case scenario that is.

I know but it was either that or an ambulance as DW can't drive at night.

 

[Alan]

Nice one Walt. Are the meds you take blood thinners, and how often do you take them?

 

[Walt34]

Nice one Walt. Are the meds you take blood thinners, and how often do you take them?

I'm on two at the moment, one for the stents installed last July and that was supposed to stop one year later. The Afib may change that so I'll have to see. That one is Clopidogrel (Plavix).

The other one started after the first event of Afib is Apixaban (Eliquis). Each one is once pill a day, I take one in the morning and one in the evening but the bottle doesn't say when, just once a day. My regular physician (internist) prescribed it.

The cardiologist raised an eyebrow at the latter since apparently being somewhat new it hasn't [FONT=&quot][/FONT]been fully tested for compatibility with Plavix. However, he said that "since it is clearly working for you I'd let it be". By that time it had been ~three weeks since the first event of Afib. The usual alternative is Wafarin (Coumadin) but that requires a lot of monitoring (blood tests) to make sure the dosage remains correct. Apparently with that one the correct dosage can be a moving target making it somewhat of a pita to use.

Sigh. So for now what they're using is working so I guess all is good....

 

[RetireAge50]

Thanks for sharing this Alan, puts all the normal discussion here into perspective. Hope this was just a one-time thing and all will be fine going forward.

I was getting dizzy awhile back. Turns out it was caffeine for me. I stopped drinking more than 12 ounces of coke and no more dizziness.

 

[Alan]

Thanks for the details Walt. Both the Docs mentioned Coumadin and we know several family members and friends on that and understand how tricky it is initially to get the levels right. Given that we plan on leaving here 2nd or 3rd week in April for several months I'm really hoping not to have to face this prospect until we get back.

 

[Walt34]

Thanks for the details Walt. Both the Docs mentioned Coumadin and we know several family members and friends on that and understand how tricky it is initially to get the levels right. Given that we plan on leaving here 2nd or 3rd week in April for several months I'm really hoping not to have to face this prospect until we get back.

This is not something you want to hear but (talk to your doc first of course) but I think I'd put that anticoagulant on the front burner. Especially if you have a second event of Afib.

Having a stroke can make all other plans vanish in one day.

 

[RonBoyd]

Thanks for the details Walt. Both the Docs mentioned Coumadin and we know several family members and friends on that and understand how tricky it is initially to get the levels right. Given that we plan on leaving here 2nd or 3rd week in April for several months I'm really hoping not to have to face this prospect until we get back.

I have been on warfarin (Coumadin) for fifteen years and rarely need to adjust the dosage. And, even then, it is very minor... a half tablet a week up or down.

The upside is that I use an office visit to run the test rather than do the testing myself. That way I get a "physical exam" every 8 weeks. My copay is $10 and the warfarin is another $6.00 (3-month supply) at Walmart.

I am very skeptical of these "new" drugs for blood thinning... even if only to be curious about who's paying for all that TV advertising. Both my PCP and my cardiologist have recommended against them for me personally.

 

[jabbahop]

another asymptomatic Afib'r here. Happens mostly when I exercise intensely. I found it looking back @ my heart monitor records from my workouts and have had it for at least 4 years.

The only scary part for me was when they put me on a Holter monitor to capture an event. I captured one and uploaded it to the service. They looked at the result and called an ambulance to take me to emergency room because there were a couple of beats that looked like Vtach (apparently Very serious).

So I am in my biking gear and they have me lie on the floor and hook me up to monitor, IV, etc. while my wife and kids are standing around.

In the end nothing to worry about - now cardiologist is just watching it.


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[Alan]

another asymptomatic Afib'r here. Happens mostly when I exercise intensely. I found it looking back @ my heart monitor records from my workouts and have had it for at least 4 years.

The only scary part for me was when they put me on a Holter monitor to capture an event. I captured one and uploaded it to the service. They looked at the result and called an ambulance to take me to emergency room because there were a couple of beats that looked like Vtach (apparently Very serious).

So I am in my biking gear and they have me lie on the floor and hook me up to monitor, IV, etc. while my wife and kids are standing around.

In the end nothing to worry about - now cardiologist is just watching it.


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Encouraging - thanks. A few things I will put into place after doing some reading today, and seeing the feedback here.

1) Don't panic. This was my first instance of Afib and it corrected itself. Worrying excessively is going to increase the chances of it happening again

2) Cut back on the real heavy aerobic exercise and do more yoga type exercise. Controlled breathing is good.

3) Cut out or greatly reduce caffeine and alcohol. I often have 3 drinks in an evening, and while DW drinks no caffeinated drinks after lunch I don't hold back.

4) Keep control of weight and BP (both are in range currently)

5) Drink plenty of fluids to stay hydrated

 

[swakyaby]

Alan,
Glad to hear you will be evaluated by a cardiologist. Be sure to mention that, although infrequent, occasionally your heart rate will drop to 35 or 36. I think that's a significant piece of medical history. In addition to a EKG, I would predict the cardiologist may order an echocardiogram to look for any abnormal heart valve leakage (regurgitation), wall motion abnormalities, heart chamber size, or existing blood clot (thrombus) in the atrial heart chamber. If he/she thinks your history is reliable in that you only had brief episodes of arrhythmia, he may decide to forego any anticoagulant and instead place you on an antiarrhythmic to keep your heart in a normal sinus rhythm. Don't fret about getting a electrical cardioversion -- they only reserve that for people who are symptomatic or who fail chemical cardioversion. Let us know how your appointment on the 25th goes.

 

[Alan]

Alan,
Glad to hear you will be evaluated by a cardiologist. Be sure to mention that, although infrequent, occasionally your heart rate will drop to 35 or 36. I think that's a significant piece of medical history. In addition to a EKG, I would predict the cardiologist may order an echocardiogram to look for any abnormal heart valve leakage (regurgitation), wall motion abnormalities, heart chamber size, or existing blood clot (thrombus) in the atrial heart chamber. If he/she thinks your history is reliable in that you only had brief episodes of arrhythmia, he may decide to forego any anticoagulant and instead place you on an antiarrhythmic to keep your heart in a normal sinus rhythm. Don't fret about getting a electrical cardioversion -- they only reserve that for people who are symptomatic or who fail chemical cardioversion. Let us know how your appointment on the 25th goes.

Good point, I will tell him about the occasional low heart rates in the 30's. And thank you for the reassurances. I did have stress test with a cardiologist in 2008 when my HR was 39 on the EKG during my annual physical at work, but I've not had an echocardiogram before.

 

[RonBoyd]

but I've not had an echocardiogram before.

Yeah, I forgot about the echocardiograms. I had two types. The first was the Transesophageal Echocardiogram (TEE) where they stick a tube down your throat to look at the back side of the heart. I didn't like that at all... even though I was under general anesthesia. A year later, I had a normal (regular?) one with the jelly all over the chest. and then a year or so later another one (The regular kind) to compare it to the first. It has not been suggested since.

The issue here, if I understand it correctly, is that with a rapid heart rate your heart like all other muscles can increase in size. This expansion causes the valves to not seal properly.

 

[bingybear]

You guys start a monitoring thread and then switch the topic to a bunch of scary S*it.

BTW, I took a copy of the gym workout and BP/HR readings to the cardiologist and he was almost astonished - "Nobody ever does that!" was his comment.

I have found that the machines in the gym I go to don't read accurately any more... so telling my cardiologist those numbers would be worthless. I would have to test other meters to see if they'd measure accurately. My Omron seems to be reasonably correct.

A couple years ago @ 51 I experienced a couple of intense light headed spells that were very short lived in the middle of a day when sitting. Two days later while checking into a hotel (business trip), I experienced the same thing but also lost my vision for a short period. When it happened, I noted to the hotel clerk that "something is not right" and she responded with "do you want me to call an ambulance?" I said no... the feeling went away, and I checked in and went to my room. The morning of the second day after checking in, I got up early and ws waiting for some people on a coach in the hotel lobby when I had the feeling again. I blacked out twice, the second time I remember having to sit back up as I had slumped over. I flew home that morning and had DW pick me up from the airport and went to the ER (emergency room... not early retirement ).

I'll skip some of the details.. When the episodes were not happening... I felt fine. I was admitted and was passing all the tests. They were about to send me home, but one test was taken late so they kept me overnight so he could read it in the morning. That night I have 3 more light headed episodes... the constantly monitored EKG did not alarm. After the second one I gave them the gory details of it and the nurse looked back through the electronic records. She found it, the signals on the top of the heart were just fine... but every now and then the signals on the bottom vanished.

So they fitted me with shiny new pacemaker (I think it was shiny and new) that paces conditionally. I did not like the idea at all when they first told me that I was getting one.
Limitations...

1. Will not let my heart rate go below 50 -- doc does not want to be called in the middle of the night by ER thinking I have arrhythmia.
2. Will not let my heart rate go above 150 -- limit of the tracking of this pacemaker... advantage of this pacemaker is that I can still get MRIs.
3. EMI Issues, such as cannot work on a car under the hood while running -- need to keep away from ignition system or other high EMI sources. Note that I spend most of my career working in high EMI projects.
4. Many HR meters don't read accurately when the pacemaker is pacing. Omron seems fine, machines at the gym just don't work reliably.

Orders from the cardiologist on exercise... whatever you were doing before... keep on doing it. If the strap from the backpack bothers you (where it crosses the pacemaker)... just get a pad to cover it. I can still push DW when hiking even with the 150bpm limitation.

Alan... hope all goes well. Hopefully the resulting treatment will not be too limiting.

ER's @53 ... this month. Now that it is warming up... time to get hiking!

 

[jabbahop]

wow bingybear - that sounds scary. Glad they caught it and that it didn't get you on the flight home!

I just got the "no HR over 150" recommendation - not due to a pacemaker but to an aortic aneurysm. Apparently the higher the HR, the higher the blood pressure (I have naturally low BP) so they want me to avoid that. It meant no more bike racing but other than that 150 isn't big limiter for most exercise. Enjoy your hiking!


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