PVCs after Stress Test

Hello,

I posted a couple of weeks ago about somewhat large Left Ventrical (mass 268 (but index 111)). At that same time I emailed my EP. He emailed back and said "sorry we should have discussed that finding at our appointment". I was to do another stress test (I think to check BP) and then see him. I did the stress test this morning and see him tomorrow. Stress test got up to 89% which is hard for me....my heart doesn't go very high during exercise...usually 120 bpm and I'm gassed...why that is, is another question altogether. So rate went up to 142....way higher than it's been in probably 15 years lol. Sinus rhythm throughout exercise. Then sat as soon as done and PVCs started. Quite a few...maybe 10, but hard to tell . Over about 1-2 minutes and then they stopped. This combo of exercise and then pvcs doesn't look like a good thing on Dr Google. This is the only time it has happened...and the only time I've pushed myself to what felt like the brink of death effortwise. Has never happened after cardio at the gym. My BP if it plays in to this story was a little high at the start 150-100...went to 200/90 maybe 80 during exercise and then recovered to 150/? Any ideas what all of this means?? As usual, a little worried.
Thanks.

Ectopics following a treadmill session at close to 90% max doesn't sound unusual, especially if you're not used to such high exercise heart rates. I passed my last exercise stress test, but went into afib right after and would have been happy with simply ectopics As long as you pass the test, I would not worry about the ectopics or anything else. So maybe quit "Dr. Google" until you speak to your doc about the test results.


Jim

Higher BP during exercise is usual.

Here is what ChatGPT4 says about PVCs after high intensity exercise, it will be interesting to see what your doc says:

Dehydration and Electrolyte Imbalances: Intense exercise can lead to dehydration and the loss of important electrolytes, such as potassium and magnesium. These imbalances can increase the risk of PVCs. Staying well-hydrated and maintaining balanced electrolytes is crucial.

Increased Sympathetic Nervous System Activity: High-intensity exercise stimulates the sympathetic nervous system, leading to an increase in heart rate and blood pressure. For some individuals, this heightened activity can trigger PVCs.

Caffeine or Stimulant Use: If you consume caffeine or other stimulants before or after exercising, it can exacerbate PVCs, as these substances can affect the heart's electrical activity.

Underlying Heart Conditions: Individuals with certain heart conditions, such as cardiomyopathy or arrhythmias, may be more prone to experiencing PVCs, especially during strenuous exercise.

Overexertion: Pushing yourself too hard during exercise can increase the risk of PVCs. It's essential to maintain a level of intensity appropriate for your fitness level and gradually build up your exercise capacity.

Stress and Anxiety: High-intensity exercise can be mentally and physically stressful. Stress and anxiety can sometimes lead to an increase in PVCs in susceptible individuals.

If you experience PVCs after high-intensity exercise, it's important to take the following steps:

Hydrate: Drink plenty of water before, during, and after your workout to prevent dehydration.

Monitor Electrolytes: Eat a balanced diet and consider replenishing lost electrolytes with sports drinks or electrolyte supplements, if necessary.

Limit Stimulants: Avoid caffeine or stimulant-containing substances before exercise, as they can trigger PVCs.

Warm-Up and Cool Down: Begin and end your exercise routine with a proper warm-up and cool-down to gradually increase and decrease your heart rate.

Know Your Limits: Avoid overexertion and listen to your body. If you consistently experience PVCs during or after exercise, consider reducing the intensity and duration of your workouts.

Thanks Jim. Thanks George.......certainly no cooldown after stopping the stress test, so I think might have been avoided with a cooldown and heart rate and level of exertion was way too much for my age...I won't go that high again even for a stress test.

How true George!
“ Stress and Anxiety: High-intensity exercise can be mentally and physically stressful. Stress and anxiety can sometimes lead to an increase in PVCs in susceptible individuals.”

I was scheduled once for a pvc ablation (33% burden) and my local EP wanted me to humor him by postponing the ablation and try an experiment. I was on multaq at the time so my EP was careful and started me week one to take 12.5mg atenolol a day. Nothing. Week two 25mg atenolol daily. Nothing. Week three after three-four days on 37.5mg atenolol a day my PVCs stopped cold turkey. That day was the date of my cancelled pvc ablation.

My PVCs just returned this week since having no PVCs since 2020. I like Cardizem because it’s a hr and BP drug for me. I don’t want to switch back and will watch it.