AIBU to think my so should see the Doctor

[Queentwatoftwatsville]

My son is 18, he’s always been very active and since finishing his exams has started training hard at the gym. A couple of things are concerning me, he is getting chest pain during and after exercise, which I know could be caused by a number of things and when he is on the treadmill his heart rate is going up to 190bmp which seems a lot but might be totally normal when pushing hard.

There is a history of heart disease in my husband’s family and I think given what’s happening when he exercises he should get himself checked out. He doesn’t think it’s necessary, so am I being unreasonable?

Yanbu, you aren't scare mongering, chest pain while exercising is not a good result.

Yes. Young adults can suffer from undiagnosed or idiopathic conditions. Co ditions which a simple ecg would pick up. Please do.

He needs to see a doctor. And probably stop training until he does.

220 minus age is max heart rate so he's fine at 190 assuming he is working hard, it could go higher. I'm 40 and heart rate peaks at 170ish.

The chest pain I would get checked out just for peace of mind.

When I was a teen I had something called precordial stitch which caused stabbing chest pains. I thought I was having a heart attack whenever it happened. It usually happens in teenagers / young adults.

YANBU

Chest pain in a young adult could be serious. Could also be nothing but wiser to get it checked.

No, 190 beats per minute is not normal despite what the shark upthread wrote-he's in a dysrhythmia and needs the attention of a cardiologist. At the least he's in a supraventricular tachycardia or atrial fibrillation with a rapid ventricular response. Trust me 190 b/ m would get medication or a defibrillation. I've been an RN 20 years and I work with cardiac patients

I spoke to our GP surgery and they offered him an appointment this afternoon, he won’t go so I’m really at a loss as to what I can do now.

Maybe you can express your concern to him this way "Son your heart rate that fast can lead to you blacking out and you may be disqualified from driving unless you have it addressed by the doctor." Some people have a genetic syndrome to these rapid heart rates and need a procedure called an ablation where the troublesome heart tissue is cryo frozen or electrically zapped for lack of better word or placed on medication such as a beta blocker heart Rx.

If you are funding the gym then you withdraw that funding until he’s been checked.

@EKGEMS that's while exercising, not his resting rate. I agree that he shod get checked but I think your comment may be unnecessarily scaring the OP.

"220 minus age is max heart rate". It really isn't, otherwise I'd be dead every time I go for a run. It's a theoretical guide to how high to let your heart rate rise if you are zone training.

@EKGEMS you could have bothered to read the OP before wading in.

It does not make the heart rate any less dangerous because it's only an exertions heart rate vs resting! And don't scold me for supposedly not reading the OP

Try showing him or asking him to go for a test via CRY, they do clinics all over the country for teenagers and young adults, I got my son checked out when he was younger after reading about the death of a young man from a heart defect, he hadn’t known about, I’d seen him playing rugby in the daily mail schools final the year before

So your heart rate is 190 b/m with exercising? Her son is having chest pain which means the pulse is putting too much of a demand on his heart to meet his oxygenation demands to his body.

Oh yeah forgot about the chest pain - sorry. But 190 bpm is fine during exercise, that was my point.

I think he is scared and that is why he is digging his heels in, his father has been taking tablets for high blood pressure since he was in his early twenties, his Grandfather had his first heart attack at 39 and two of his Grandfather’s brothers suffered sudden cardiac arrests and died before they hit 50. He pays for the gym himself, so I can’t threaten to cut that off.

A HR of 190 on proper exertion is fine in an 18 yr old so long as he’s not getting symptoms beyond feeling appropriately out of breath for that level of exercise. There are lots of possible causes of chest pain - some are worrying, others are not - and although it’s unlikely to be anything serious in an 18 yr old the only way to be certain is to see a doctor in real life.

As our cardiac nurse upstream should know, the chances of an 18 yr old having AF are vanishingly unlikely. An SVT is possible, but he’d be pretty unlikely to be able to exercise through it (because it usually feels bloody awful). An exercising HR of 190 doesn’t mean he needs a defib (and again as the nurse upstream should know, a narrow complex dysrhythmia also wouldn’t earn anyone an implanted defib!).

Depending on exactly what the family history is he probably should see his GP, but 18 yr olds are allowed to make their own decisions. If the family history is of old people having angina/heart attacks that’s probably less worrying, but if it’s sudden cardiac deaths/cardiomyopathies in young people that’s more alarming (hopefully the whole family would probably already have been screened if that were the case though). A resting ECG won’t pick up everything, but if it’s completely normal that’s pretty reassuring. There are some other non-invasive investigations which may be appropriate depending on the exact history.

Thinking very slightly outside the box it may be worth gently exploring possible drug use - cocaine is one of the commoner causes of heart attacks in young men (although is not your average 18 yr old gym bunny’s poison of choice).

COI am not a cardiologist (but am an doc [who can still get their HR up to 190 when exercising and hasn’t died yet!]).

Ah, cross posted... That family history does sound relevant. Hope he can be persuaded to see someone.

So glad a doctor weighed in! I hope the young man is in perfect health and it's a one off. Never thought he'd drop dead at 190 but the chest pain with it is concerning. Sorry OP if I scared you I necessarily :(

Unnecessarily

@EKGEMS No apology necessary, thank you for your advice.

Thank you OP.

You CAN threaten to ring the gym and inform them that he needs his heart checked and explain why, so that they can prevent him working out until he is deemed safe by the GP. Cruel but kind.

Had thought about ringing the gym, he’s there now. But do you think they would actually act on it?