Any cardiologists our there?

[Heartquestion]

A bit of background:

I have had heart palpitations all my life. Had them investigated with an ECG years ago and was told they were benign. They are pretty regular (every few days) but don't bother me. They are worse if we I drink too much caffeine and am stressed.

I also have a low resting heart rate-usually about 57. I am pretty fit, work out a lot and run regular half marathons.

I'm also known for having white coat syndrome with my bp although I had high blood pressure in my two recent pregnancies. My children are 3.5 and 1.5

Recently a doctor sent me for some investigations. My bp was high in the surgery and a heart murmur was detected. This is not the first time this has happened. I got investigated about 5years ago for the same issue. Back then the ECG was fine, ECHO was fine and my bp was put down to white coat syndrome as regular checks of it proved it was fine. Again, I have been checked for bp issues all my life (I'm 37) now and all tests show it's white coat syndrome.

My recent bp tests were fine and my recent ECG was fine however my ECHO is scheduled for a few weeks time right after an endurance event where I will be walking a marathon over 24hrs up hill.

My doctor has told me not to do it. He says putting a strain on my heart whilst the investigations aren't complete is unwise. However, he also says a benign heart murmur turning into a dangerous one in 5 years is unlikely. I really want to do this event and have raised a lot of money. Cardiologists, do you think he's just covering his back?

Bump

Not a cardiologist but a marathon runner with a heart condition. Endurance events do have (albeit temporary) effects on the heart. I'd probably listen to the cardiologist to be honest. Let's face it, they know their stuff.

Pressed send too soon. Your cardiologist knows your case, no one else on here does. They will have differential diagnoses they're considering which will form the basis of their advice.

One of two things may happen - whatever the problem is (if anything) may be exacerbated by the event, or the event may physiological changes which alter the outcome of the investigations.

pregnancy means the heart will have to work harder. That on top of exercise you are being warned to avoid isn't the doctor covering his back. If it was nothing he would not be doing tests. He is telling you what he feels is best.

Any chance you can get the echo done earlier? Might private be an option as a one off? (Also not a cardiologist)

sorry for some reason i thought I read you were also pregnant now.

I'd probably be pressing for a cardiac MRI if I was your GP.

I'm not a cardiologist but I can pretend to be one if you like !
My layman's advise is don't do it.
Why take the risk? Nothing is more important than your health and your life.

I've you actually given up coffee and tea all together as well as alcohol? These alone can cause problems with some people. My boss had very bad palpitations for years, wouldn't give up the above as enjoyed them too much but in the end, tried to do so for 3 months. The palpitations and anxiety stopped all together.

57rhr is not that low especially if you are very active. 57/58 is my high rhr, it goes down to 48/49 at times (42 at times at night) and that's when I feel quite lightheaded the next day.

As you definitely want to do the marathon can the Echo be done earlier? I have similar symptoms to yours but I am older and only been investigated recently. I don't do marathons or any endurance sports and frankly I would feel uneasy about it if I did and the doctor advised against it. As much as you want to do it your health should be your priority.

Thanks for your responses. Just to clarify two points I'm not pregnant and the advice was from a gp not a cardiologist. He told me his instinct was it was all benign and seeing as I have had an ECHO 5 years ago which turned up nothing at all it was probably fine but he couldn't say for sure.

Is a heart MRI the same as an ECHO? The one I have had before and am due to have after the event is the one where they screen you with gel on your chest and look at your heart in depth, similar to when they scan you in pregnancy.

MRI and Echo are not the same - echo is the one that's similar to a pregnancy scan.

Don't do it. My husbands wasn't detected until just after he'd run one. Cardiologist said he was very lucky.

I'm a big fan of endurance exercise but I know that excessive and prolonged endurance exercise can be counterproductive with regard to heart health,
It's a no from me
(Not that I am a cardiologist you understand)

Thanks I suppose what I really want to know from a cardiologist is if you have had multiple investigations 5 years ago what are the chances of there suddenly being a problem now.

I've paid a lot of money for this event and raised over £2k for a charity. It would be a real shame to ruin it all for nothing and my instinct is it's nothing.

I would wait until you've had the echo. Push for a stress echo if you can - where you have one done during strenuous exercise.

There are always sports cardiology specialists you could go and see before the event if you have the money to help you make a decision. They will do a full investigation and know far more than a GP.

www.athletesheart.org
I found this blog quite helpful on this subject

I'd pay to have tests before the event. I'm an endurance bod with SVT who has continued to walk/run albeit slowly.

Thanks again for all the responses and of course if I believed there was a big risk I wouldn't be considering it at all. I just don't see how anything can have developed in 5years.

Does anyone have any experience in that area specifically? For example an echo, multiple ECGs missing a major issue?

Ps I have just enquired to pay privately for an echo. It's just such bad luck to have the free echo scheduled two days after the event when I am pretty sure there is going to be nothing wrong. I don't have private insurance so I'm looking at paying out a lot of money for this.

Do you know what I would do OP, if the cost is prohibitive, I would miss the event, wait for the NHS test and if given the all clear I would just enter another similar event as soon as possible. That way you aren't letting the people down who have sponsored you and you will feel you have earned your money. I did a sponsored marathon and was so worried I'd be ill or something but decided I would just enter one the following week if that was the case. If I was sponsoring someone it wouldn't change how I felt one jot if it was a different event that you took part in. Most people won't even remember the date, it's only really important to us the partaker 😊

*Thanks I suppose what I really want to know from a cardiologist is if you have had multiple investigations 5 years ago what are the chances of there suddenly being a problem now.

I've paid a lot of money for this event and raised over £2k for a charity. It would be a real shame to ruin it all for nothing and my instinct is it's nothing*

I had cardiac investigations (investigating tachycardia). I had ECG, echo and MRI, all normal.

10 years later, investigations picked up my condition, the first symptom of which is usually sudden death. I have a form of cardiomyopathy, similar to that of people like Fabrice Muamba and other such athletes who just drop dead without warning. Despite running marathons, cycling over 200 miles a week, I actually had heart failure. I had an MRI on the Thursday, was called in urgently on the Friday morning to discuss and was booked to have an internal defibrillator fitted by the end of the following week.

Can you defer and do the event next year when you know what's what?

What is the event anyway? National 3 Peaks?

Thanks Sorry to hear of your issues and how lucky you were.

Yes it's the three peaks.