Skip to content
Includes Expert Content
question about MVP, high pulse rate
avatar
pallava posted:

My first post here. Will try to keep this short, to the point. 43-yr old single Asian Indian male, living in the UK. Family history of coronary artery disease, on dad's side (dad's brother, dad, his brothers etc). Dad is 79, alive, teetotaller, lacto-vegetarian, but heart condition is pretty bad. Severe LV dysfunction after a silent myocardial infarction on left anterior wall possibly decades ago.

I have been careful about my health : eat sensibly, drink in moderation, non smoker. Gave up red meat at 40. Now mostly lacto-vegetarian, with occasional fish/prawns/eggs. Consume low fat milk / yogurt. Moderately active physically but not an athelete.

Problem : Pulse rate occasionally very high, into 100s. Why ? I can jog 20 minutes on treadmill without panting, but after the jog, pulse rate stays close to 100 for 1 to 1.5 hrs. I have heard that this is dangerous. When I climb three flights of stairs, I pant and my heart rate goes up to 90s. When I wake up, it is 58 to 60. As I walk about, it is around 70 to 75. After lunch or dinner, it can go up to 82, but after a slightly heavy meal, it even touches 90. The other day as I went to see the doc, I had a lunch buffet at the hospital and post lunch, my BP was 120/80 but my heart rate was 106 !

Blood pressure has always been normal : 120/80 etc. Cholesterol, triglycerides also normal. My HDL is good. No sugar / diabetes.

Recently after dinner, I had chest pain radiating to back of the shoulder, heavy indigestion so I went to the local doc. My BP, sugar was ok, but he said ECG is not looking good : I had "ectopic". This is in India in a small clinic, and they admitted the ECG machine was faulty the day before, so I went to the biggest hospital. They monitored me the whole night : 3 ECGs, all normal, 2 troponin tests (cardiac enzyme) all normal. They also did a CT-Angiogram in the morning : good news, I have no calcium deposits and coronary arteries are clean, not blocked at all. I insisted upon an echo-cardiogram test, and it looks ok (67% Ejection fraction, everything else fine) but I have MVP : Grade-I Mitral Valve Prolapse (AML). I am 5 ft 10" height, 63 kg.

They also did an endoscopy and I have reflux oesophagitis LA Class A Antral gastritis.

Questions :
*) Should I be worried about the MVP ? My doc hasn't given me a medicine, but asked me to maintain good dental hygiene to minimize infection risk. Does infection on mitral valve happen and is it dangerous ? And how would someone know anyway that their mitral valve is infected ?
*) Why is my heart struggling (panting, pounding, high pulse) after climbing up a flight of stairs ? Is it because of the mitral valve prolapse ?
*) why is my pulse so high occasionally ? And is it dangerous ?

Thanks a lot in advance.
Reply
 
avatar
cardiostarusa1 responded:
Hi:

"But after the jog, pulse rate stays close to 100 for 1 to 1.5 hrs. I have heard that this is dangerous."

The Basics

Normal resting range heart rate (HR) is 60-100 beats per minute (BPM). Average resting HR in men is 72-78 BPM and in women is 78-84 BPM. Over 100 BPM is tachycardia (fast heartbeat).

Heart rate, as well as blood pressure, should rise gradually/accordingly during activity/exercise/to the intensity of the activity/exercise.

Additionally, heart rate recovery (HRR) is very important. This is how fast the heart rate returns to normal (for the individual) after vigorous exercise/physical activity, with the first minute being the most critical or tell-tale. The heart rate should gradually and smoothly return to normal within several minutes. Blood pressure (BP) response after is naturally very important as well.

"Should I be worried about the MVP?"

Not necessarily, though mitral valve prolapse (MVP, the most common and typically benign heart valve abnormality) may/can progress to mitral valve regurgitation (leakage) at any time.

Some individuals with MVP experience no symptoms at all, or symptoms such as palpitations, and sometimes even chest pain, especially when lying on the left side (as the heart is brought closer to the chest wall).

MVP, described as a distinct billowing inward of the mitral valve's leaflets.

Normal mitral valve

Mitral valve prolapse

"Does infection on mitral valve happen and is it dangerous?"

Yes, and it may/can be.

"And how would someone know anyway that their mitral valve is infected?"

Info on commonly reported symptoms, and diagnostics, can be found on the Net.

"Why is my heart struggling (panting, pounding, high pulse) after climbing up a flight of stairs?"

This can not be truly determined here.

"Is it because of the mitral valve prolapse?"

It's a possibility.

"Why is my pulse so high occasionally?"

This can not be truly determined here.

"And is it dangerous?"

Often no, that is, say, unless there is a substantial or severe structural problem or defect in the heart

Best of luck down the road of life

Take care,

CardioStar*

WebMD member (since 8/99)



-

-

Be well-informed

WebMD

Heart Disease TYPES

Men and Women

Acquired or (born with it)

http://www.webmd.com/heart-disease/heart-disease-men


Heart disease SYMPTOMS


http://www.webmd.com/heart-disease/guide/heart-disease-symptoms


Mayo Clinic

Heart Disease

Definition. Symptoms. Causes. Risk factors. Complications. Tests and diagnosis. Prevention......

Heart disease is a broad term used to describe a range of diseases that affect your heart, and in some cases, your blood vessels. The various diseases that fall under the umbrella of......

http://www.mayoclinic.com/health/heart-disease/DS01120



LEARN ABOUT the Heart



WebMD

The Heart: (Human Anatomy) Pictures, Definition, Location in the Body and Heart Problems

http://www.webmd.com/heart/picture-of-the-heart


WebMD Health/The Cleveland Clinic

How the Healthy Heart Works

Arteries, Chambers, Valves

http://www.webmd.com/heart-disease/healthy-heart-works

Your-Doctor

How the Heart Pumps

Animated Tutorial

http://your-doctor.com/healthinfocenter/medical-conditions/cardiovascular/heartpump-tutorial.html


-

Quote!

Be a questioning patient. Talk to your doctor and ask questions. Studies show that patients who ask the most questions, and are most assertive, get the best results. Be vigilant and speak up!"

- Charles Inlander, People's Medical Society



It's your future......be there.

. .

WebMD/WebMD forums DOES NOT provide medical advice, diagnosis or treatment.
 
avatar
billh99 responded:
I would ask about getting a Holter monitor test or an event recorder.

The holter is a small EKG, that just has 4 lead, about the size of a package of cigarets that you wear for 24-48 hours. And you keep a log of your actives. So, for example, you would write down the time that you climbs the stars and was short of breath.

An even record is similar, but you wear it for 30-60 days. But it does not record continuously. Rather you push a button when you have an even and it records a sample of the heart rate before and after the event.

I don't know how big an area that you are in, but an electrophysiologist is a cardiologist that specializes in electrical problems of the heart.

but asked me to maintain good dental hygiene to minimize infection risk.

I don't think that current studies indicate that there is any problem with an dental infection cause a problem with the mitral valve. However there is very strong indication that dental infection (gum disease) does cause inflammation in the body and leads to increased plaque buildup in the arteries.
 
avatar
HeartDeviceInfection replied to billh99's response:
We would like to invite you to HeartDeviceInfection.com to learn more about preventing heart device infections and to register to receive educational articles and information on preventing heart device infections.
 
avatar
pallava replied to billh99's response:


Thanks CardiostarUSA1 and BillH99 for the responses. Much appreciated.

I am based in the UK but right now on business / family visit to India. I have gone to one of the biggest and most famous hospitals here. It is supposed to be a great hospital with excellent doctors but the doctors are always extremely extremely busy attending to severely ill patients. So it is a bit difficult to find adequate time to discuss things with the cardiologist.

Even the echo-cardiogram was done upon my request. When I was hospitalized, as I mentioned, they took 3 ECGs during the night, couple of troponin tests, and a CT-Angio. They were all normal. Since the CT-Angio result was great, so there was no need for further investigation from a cardiac standpoint.

The echo-cardiogram was done at my insistence and thats how we found the MVP. The doc said not to worry about it. When I asked him about the high pulse rate, again he said not to worry about it and could not give me a reason as such. However he prescribed Metoprolol drug (25 mg slow release) which is apparently a very low dose. I am reluctant to take medicine without knowing the reason why my pulse rate is occasionally high and especially why it is high for a full hour after exercise. The simple explanation could be that I am not a well trained athelete and with regular conditioning, things might be improve. But I would like to hear the same from the cardiologist. Also, he did not refer me to someone who specializes in electrical activity of the heart. I asked about Holter monitor and again the response was that I probably dont need it.

Perhaps doctors have more urgent issues to worry about, here in India. Maybe when I get back to UK, I can consult with my GP.

I have some questions tho' :

CardiostarUSA1 > Additionally, heart rate recovery (HRR) is very important. This is how fast the heart rate returns to normal (for the individual) after vigorous exercise/physical activity, with the first minute being the most critical or tell-tale. The heart rate should gradually and smoothly return to normal within several minutes. Blood pressure (BP) response after is naturally very important as well.

So a TMT test would be the best to test the above ? I asked about TMT and the cardiologist said that I dont need it because the CT-Angiogram has already shown clean arteries and therefore the TMT would not reveal additional info.

[me>>>"Why is my heart struggling (panting, pounding, high pulse) after climbing up a flight of stairs?"
[me>>>"Why is my pulse so high occasionally?"
CardiostarUSA1 > This can not be truly determined here.

So, how to find the answers for above ? or, is it "nothing to worry about " as my cardiologist advises ?

Oh by the way, I did a Lipid profile test 2 days ago : my HDL is 52, LDL is 77 and triglycerides is 109. 5 years ago the numbers were 66, 92, 101.

Thanks again.
 
avatar
cardiostarusa1 replied to pallava's response:
You're welcome.

BTW: An HDL level of 60/65 mg/dL or more is considered protective against coronary artery disease (CAD).

......heart rate recovery (HRR)

"So a TMT test would be the best to test the above?"

Right.

Plus, read this -

New England Journal of Medicine - archives

Heart-Rate Recovery Immediately after Exercise as a Predictor of Mortality


Conclusions

A delayed decrease in the heart rate during the first minute after graded exercise, which may be a reflection of decreased vagal activity, is a powerful predictor of overall mortality, independent of workload, the presence or absence of myocardial perfusion defects, and changes in heart rate during exercise.

http://www.nejm.org/doi/full/10.1056/NEJM199910283411804

Also, seldom talked about/discussed here, and as only deemed applicable to the patient by a qualified doctor, there is a highly-specialized treadmill test called the Microvolt T-Wave Alternans (MTWA) Test.

This is a non-invasive test to help identify patients at risk of life threatening heart rhythm disturbances, which may/can lead to absolute worst case scenario, sudden cardiac arrest (SCA). A treadmill stress test is very similar to the MTWA test.

Additionally, and noteworthy, like any other non-invasive diagnostic imaging modality or test, CT angiography is not 100% perfect. It has its inherent limitations, its strengths and weaknesses.

"Why is my heart struggling (panting, pounding, high pulse) after climbing up a flight of stairs."

This can not be truly determined here.

"So, how to find the answers for above, or is it nothing to worry about, as my cardiologist advises?"

Since your heart is acting the way it does, which is obviously not normal after walking up some stairs, do feel free to seek, in-person, as many additional professional medical opinions as necessary until you are 100% completely satisfied/confident with the diagnosis, treatment and prognosis.

Take good care,

CardioStar*



-

-

Quote!

Be a questioning patient. Talk to your doctor and ask questions. Studies show that patients who ask the most questions, and are most assertive, get the best results. Be vigilant and speak up!"

- Charles Inlander, People's Medical Society


.

It's your future......be there.

. .

WebMD/WebMD forums DOES NOT provide medical advice, diagnosis or treatment.
 
avatar
pallava replied to cardiostarusa1's response:

Thanks again CardioStar. Yes, a few months ago, I had seen that article about delayed heart rate recovery, upon some googling, when I just happened to observe that my heart rate was not coming down quickly enough after a 25 min jog.

Now, I have indeed mentioned this particular behaviour of my heart rate to my cardiologist, I wonder why he is not suggesting further investigations. I did not cite the article to him tho'.

I now remember that my health insurance company at my employer came by a year and half ago to our office to to promote some of their preventive checks. It was like a corporate wellness day thingy. One of the items was to ask the individual to do a 5 minute climbing exercise and then immediately monitor the heart rate. Mine was pretty high for a while, but they just said that I was poorly conditioned and I could benefit from some regular exercise and 'train' the heart.

But the article you cited does sound alarming and I am not sure now whether I could improve things just by doing regular exercise or maybe there is something more scary going on.

Thanks.
 
avatar
pallava replied to pallava's response:

Update : I eventually managed to get a TMT test done while in India - this was in mid Jan. It was quite satisfactory according to the cardiologist at this really good cardiac centre I went to. I did a "Bruce" TMT test. I was almost able to complete the test, i.e went up to Stage 4. My heart rate went upto 179 bpm, and blood pressure went upto 180/90. Another minute or so, and I would have finished the test, and as I had just crossed 179 pulse, the test was switched off. And then the recovery started. In the first minute, pulse came down to 151 bpm, in the next minute it came down to 126 bpm, then 115 bpm in the next minute, and then it hovered around 109 for a few minutes and then came to around 100 and then the test was stopped. I was informally measuring my pulse for the next 30 minutes and it stayed around 100. Must have taken about an hour to come back to my 80 bpm pulse.

The cardiologist said the test was good and I have nothing to worry about. His words were : "Your risk of sudden cardiac arrest is very very low". For the occasional high pulse, he advised me to take a low dose of beta blocker. But I was inquisitive and wanted to know the reason. So he has asked me to do a Holter Monitor test. I am now back in the UK and my GP says he can approve a Holter Monitor test.

I also started some meditation and Yoga while in India for a month but have discontinued after coming back to the UK.

I want to avoid medicines if possible.

Thanks.
 
avatar
gosain replied to pallava's response:
I am extremely worried, because my wife has highly flactiuatung pluse rate. it is down to 50 and 123 on the up side. She is under treatment for the last 3 years as she had a stroke and was paralised for about 30 minutes. bur since fully recovered from it.
Her dicotor a DM and well established in heat care and operation do not take it serciously, and treating her with same medicines as before.
I want to know what is your advice.
jmgosain@hotmail.com
 
avatar
James Beckerman, MD, FACC responded:
Thanks for your post!

Q1: I don't think you should be worried about the MVP. It sounds as though your mitral regurgitation is not significant, and your heart appears structurally normal.

Infections on valves are generally uncommon, particularly in people without prior valve replacements. It is smart to maintain good dental hygiene, although antibiotics would not generally be recommended in your situations.

Infections are associated with fevers and fatigue in many people.

As far as Q2/Q3 - it's hard for me to say. It may be worthwhile for you to wear a heart monitor for 24-48 hours to document your heart rates, see where they average, how it responds to exercise, etc. More information can be helpful - and reassuring too.

Take care!
 
avatar
pallava replied to James Beckerman, MD, FACC's response:

Dr.James Beckerman, thanks a lot for the response. Thanks for taking the time. much appreciated !!

Question about blood pressure : Until now (I am 43 now), I have managed to avoid taking any blood pressure medications. I have always maintained 120/80. At about 36 years of age, my blood pressure was creeping up to 135/90 or even 140/90. I used to consume a lot of salt in those days. After that, I stopped adding extra salt while eating. And since then, I have maintained 120/80. Last year, I was travelling on business a lot, and eating out, and the blood pressure creeped up to 125/90. I started deep breathing exercises and Yoga and it was consistently down to 120/80 for last several months. But I am lazy and unable to concentrate or find time so I gave up Yoga for last 2 months. My BP is back to 126/90

Everyone in my father's side has had high blood pressure, so I have got it in my genes for sure. My diet is quite healthy with low sodium. I have also given up alcohol (what used to be moderate drinking) in last 3 weeks and maybe thats why the blood pressure has gone up ?

Questions :
*) I suppose I should start breathing exercises again. Anything else I can try ?
*) How to measure blood pressure regularly, professionally ? I cant keep going to the doctor's every day. Most automatic machines are no good as far as I know.
*) How often to measure blood pressure at the very minimum ?

Thanks and look forward to your response.
 
avatar
pallava replied to pallava's response:


I am still wondering why my BP (blood pressure) is so high in spite of my reasonably healthy habits. Writing it more cogently now so that someone can reply.

Background, again : High BP, heart disease on father's side. I was maintaining 120/80 for a long time. I am 43 now. 7 years ago, my BP started going up to 135/90-95. I used to consume too much salt. Cut down on salt and BP has been 120/80 since then.

Travelled on business a lot last year, and BP shot up to 125/90 mid year. 10 minutes of deep breathing daily and it came back to 120/80 towards end of 2011. Yoga in January and BP was still 120/80. (even 110/75). All heart tests ok in January. In Feb/Mar in 2012, no yoga, no exercise, business travel, rich food. I didnt check my BP either. But in March 2012 I have been back in the UK. Living very healthy. Very low sodium, olive oil, lots of fruits and veg, brown rice, oats, nuts, etc, no alcohol, not much stress at work or home, walking daily to work and back (25 minute one way). No other exercise, no deep breathing or yoga. Yet my BP is 125/90 when measured 2 days ago. Why ?

I guess its in my genes, and its just inevitable eh ? I am hardly having 3 gm / day of salt. I will start the deep breathing and see if it makes a difference in a month.

On another note, eating too little salt (< 3 gm / day) is also bad for the kidneys correct ?

Thanks. Hoping someone sees this note.
 
avatar
pallava replied to pallava's response:
Hello Dr.James Beckerman and/or Dr.CardioStarUSA1, can you please respond to my query about high BP ? It appears as if my healthy lifestyle isnt impacting my high BP, almost as if I am resigned to my genes. Also, eating too little sodium is bad for the kidneys right ? Look forward to your response. Thanks ! Happy Easter !!
 
avatar
James Beckerman, MD, FACC replied to pallava's response:
Blood pressure (and its treatment!) can definitely be complicated.

We know that obesity, smoking, and alcohol use can increase our blood pressure - so regular exercise and healthy food, tobacco cessation, and alcohol moderation are the way to go. Sodium plays a role, although small. And genes unfortunately can play a big part - and we have no control over them.

Home automated blood pressure machines are actually pretty good. If you have any concerns, bring your machine to your doctor's office and have your blood pressure checked there to make sure that it seems consistent.

Most people should not need to check their own blood pressure multiple times a day - I have found that this generates stress...which can increase blood pressure. Starting out, consider checking it twice a day for a week. If it is generally elevated, then talk to your doctor about lifestyle/medical interventions to get it down.
 
avatar
pallava replied to James Beckerman, MD, FACC's response:
Dr.James,Thanks for the response !


Featuring Experts

James Beckerman, MD, FACC, is a cardiologist at the Providence St. Vincent Heart Clinic in Portland, OR. He graduated summa cum laude from Harvard Col...More

Helpful Tips

Nix Grapefruit & Statin DrugsExpert
Grapefruit & statin drugs can be a bad combination. Unlike other citrus fruits, grapefruit contains substances that disable certain ... More
Was this Helpful?
13 of 15 found this helpful

Expert Blog

The Heart Beat - James Beckerman, MD, FACC

Dr. James Beckerman shares how small, livable lifestyle changes can have a real impact on your risk of heart attack and stroke...Read More

Related News

There was an error with this newsfeed

Related Drug Reviews

  • Drug Name User Reviews

Report Problems With Your Medications to the FDA

FDAYou are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

For more information, visit the Duke Health General and Consultative Heart Care Center