new member with questions

[sueacan]

Hello All...I am a new member. I was told about this place in the Long Term Survivors forum of ACOR.com. After a cancer in my pericardium and mediastinum, surgery, radiation and chemo in 2001, it became evident that the radiation accelerated a mitral regurg problem. Had to have the mitral valve replaced 4 weeks ago. I chose a biological valve, trying to minimize the use of drugs in the future. All seems to be healing well, but about 2 weeks out my pulse rate has started to climb from the 70's to the point that my pulse never falls below 105 now and hasn't for at least 2 weeks now. Cardiologist did a ECG and Echo, said all was well, not sure why the fast pulse. My question to others having had this surgery: Is this normal? Will it go back down as I get in better shape? Should I be concerned and push for a more definitive answer as to why the rapid pulse? Any suggestions would be appreciated.
Sueacan

[Ross]

At 4 weeks out, your still healing and this could just be an electrical short temporarily. I'd certainly want my Cardio knowing about it. I would hope it starts to settle in a couple of weeks, but if you think at anytime your in AFIB, get on the phone or to the ER for conversion.

[tobagotwo]

Sueacan,

Of course, there are a number of not-so-great things that can cause rapid heartbeat. However, the most likely cause is just that your heart is working out the changes from your recent surgery.

Since your cardiologist has already done an EKG and echo, and is satisfied with those results, some other things that you might want to look into:

- Did you just go off of a beta blocker, like Atenolol? The cardio might not realize the surgeon had you on a beta-blocker scrip that expired. If so, get back on it, at least for a while.

- Consider asking for a blood test to rule out any infections.

- Are you walking? Regular, mild exercise often helps with rhythm issues.

- Magnesium supplements help some people with rhythm issues. Check with your cardio and pharmacist first, though.

I like one thing about your cardiologist - so far, at least. There are a lot of odd things that occur early in the healing process, and many cardiogists (in my inflated opinion) seem to jump the gun by giving out meds too quickly, a long-term fix for a short-term problem.

If he doesn't feel that you are endangered by that heart rate, you can live with it for a little while, and see if it slows down on its own. If that is your choice, then I suggest that you call his office and set up a point-in-time with them, when you will come in if your HB hasn't slowed down.

Best wishes,

[sueacan]

I want to thank everyone that replied to my question. I did discuss this with my surgeon and cardiologist and I think we will take a conservative path for now. It feels like a bowling ball bouncing around in my chest right now, but I think I might be stressing somewhat also. Again, thank you everyone.
Sueacan

[danielgilboa]

Hi and welcome!

Many people experience high heart rates after surgery. My HR was over 110 for about 4 weeks and very slowly came down to normal. It can be anoying. My doc recommended NOT to take any medication and I thank him for that. The least the better with the vasoactive drugs. I think being active and walking alot helped stabilize my heart activity. As long as it is regular rythm you should be OK.

Take care

[doberman]

Hi, after my mitral repair my heart rate was up over 110 at times while I was walking, but it all settled down after time and now after 3 1/2 months everything seems to be normal. The nurse at the hospital told me that my heart rate should be between 80 and 120 bpm, but I believe the upper end of 120 bpm. was not to be exceeded while excercising...Most people on this site will tell you that things are a little erratic for the first few months after surgery. Enjoy your health.
Best JD

[ShezaGirlie]

Hi Sueacan and welcome to VR.COM.

Where are you in Texas? There are a bunch of us here..and glad to see you join us.

[sueacan]

Hi Janie...I am way out in the country, but close to Floresville, south of San Antonio. By way of an update, my cardio wants me to start cardiac rehab, but my pulmonologist wants me to do pulmonary rehab first. I had lung cancer and the radiation and chemo from that is what caused me to have to have my mitral valve replaced. I am very short of breath right now after 3 years of treatment and heart problems, so my lung dr is pushing for rehab to get back as much lung function as possible. He says the cardiac rehab will wait 8 weeks and will be much easier after pulmonary rehab, but my cardio dr isn't quite happy about that. I'm not sure what to do. My pulse rate is still up over 100 but I am told that it will come down with rehab. I guess I'll do some talking to my husband and see what we come up with. Any suggestions out there?
Sueacan

[ShezaGirlie]

Well, I'm real familiar with your area. I grew up in the country near Pleasanton and went to High School there. My grandparents were from the Loire/Verdi area which is even closer to Floresville. Are you a Wilson County native? Small world, huh... :D

I don't have much input as to your pulmonary issues, but I agree that cardiac rehab is wonderful and it will help your heartrate. Is your cardiologist in San Antonio -- mine is.

[sueacan]

Hey...my cardio is in San Antonio, Dr. Laura Jacobs. I am pretty comfortable with her. I have a few other medical problems that make it hard to find any Dr that wants to take me on, but she did. Early and late effects from massive radiation treatments for cancer. Not too many Dr's are aware of the possible problems and not all want to take the time to deal with them.

I do have another question...I had a biological valve replacement so I won't have to take coumadin forever. My surgeon said 2 months, but he never said how I needed to go off coumadin. I could call and ask, but it might be easier to just ask ya'll. Should I just go off coumadin or do I need to taper off? Any suggestions?

Suacan, TX

[Ross]

When you have your Doctors blessing, you'll just stop taking it. It'll take about 2 or 3 days for your blood clotting to return to normal levels of that of a unanticoagulated person.

[ALCapshaw2]

Hello Sue,

I just read your posts and can relate to quite well to the 'side effects of radiation therapy' as I was treated with radiation for Hodgkins Disease 30 some years ago. There are a few of us radiation survivors here. You may want to read Johnny Stephens story in the Personal Stories section of this website.

An elevated HR after surgery is quite common. Your comment about your heart feeling like a bowling ball bouncing around inside your chest caught my attention. I have had several incidents of where my heart feels like a small out-of-balance washing machine in my chest.

These sensations are primarily caused by Premature Atrial Contractions (PAC's) and (less frequently) Premature Ventricle Contractions (PVC's). Most doctors consider these to be benign as long as they convert in a reasonable amount of time (several hours).

Do you have a stethoscope? Listen to your heartbeat. PAC's sound like a double beat that can occur occassionally (as isolated events) or more frequently such as once every 2 or 3 or ..... or 6.... beats. If you hear a double beat every time with NO regular beat between, you may want to contact your cardiologist to ask about going to the ER. I've had way too many visits to the ER and I usually just 'ride out' arrhythmias. So far most have converted in a few hours time. Talk with your Cardiologist and see how she wants you to handle such events. A low dose BetaBlocker (Toprol XL) kept my arrhythmias in check for several years.

I wanted a tissue valve (Bovine Pericardial) but my surgeon placed a mechanical once he saw how much scar tissue I had around my aorta. Although living with Coumadin has not been difficult, I still envy your tissue valve! ... especially when it comes to considering having other invasive procedures...

Welcome Aboard !

'AL Capshaw'

[Marge]

<< about 2 weeks out my pulse rate has started to climb from the 70's to the point that my pulse never falls below 105 now and hasn't for at least 2 weeks now. Cardiologist did a ECG and Echo, said all was well, not sure why the fast pulse. My question to others having had this surgery: Is this normal? Will it go back down as I get in better shape? Should I be concerned and push for a more definitive answer as to why the rapid pulse? Any suggestions would be appreciated. >>

From what I've been told, an elevated heart rate is not at all unusual after OHS. They've done a lot of messing around with your heart, which is still adjusting. At only two weeks out, since the tests don't show anything amiss, I wouldn't worry too much.

About two weeks after my valve repair surgery, the home health nurse who was visiting me pointed out it had been steadily going up since she started seeing me a few days after I got home -- starting out in the 90's and by that time into the 100's. (It had been consistently in the 70's-low 80's prior to surgery.) I discussed this with my surgeon and my cardio -- neither seemed really concerned. According to them, an elevated heart rate is not unusual after heart surgery and as long as I wasn't having irregular heart beats (which I wasn't) they weren't worried.

My primary physician was concerned I might be anemic (which he said isn't uncommon after OHS) and since an elevated heart rate can be a symptom of anemia he sent me to be tested for that. I wasn't anemic.

I did cardiac rehab with a (resting) heart rate that was often in the 90's and 100's -- the cardiac rehab folks were a little concerned, but worked around it. It did go down a bit during the course of the rehab.

I am now almost a year past the surgery (which was in Feb. 2004). I'm on cozaar and a beta blocker (coreg) and my blood pressure is usually around 110/60 but my heart rate is still, to my mind, a bit high (usually in the 80's. sometimes in the 90's, but it doesn't go up over 100 except when exercising).

My cardiologist still thinks I am OK, as long as I am in NSR, which I am.