touchy heart rate

[AvaWegs1377]

Dear Dr. Frett i was diagnosed with ppcm in february of 07. Since then i have greatly improved with a ef of 55%. It seems though that when i do light work say house cleaning, walking from one room to another that my heart rate is very high . I recently bought a heart rate watch and when checking it while standing its in the high 90s Im hardly doing anything at all. When at the gym on the ellyptical about 2 or 3 minutes in my heart rate is already up to 130s. Is this part of the ppcm? Im not short of breath but tired. when resting my heart rate is in the 60s to 70s. Granted I am out of shape and havent excercised in over a year now . Is this part of ppcm.?? Thanks Amanda

[JAMESFETT]

How great to already be in the "recovered" range of heart function after a diagnosis of PPCM in February 2007! What you are experiencing is part of PPCM recovery, and with you it would appear to be a matter of conditioning. If you persist in your logical exercise program I believe you will eventually see less rapid rise in heart rate with exercise. Keep up the good work.

JD

[AvaWegs1377]

Im sorry Dr. Fett but is it dangerous for my heart rate to get that high? I was on 25 mg of atenol that greatly controled the heart rate but after my last echo the dr switched me to coreg 3.12 mg twice daily . Also you mentioned being in the recovery stage already. when i was diagnosed with ppcm my acho showed a ef of 40% about 2-3 weeks after delivery. Since its been 7 months can hormones cause elvated high blood pressure? I NEVER had high blood pressure prior to delivering. Why now and why still. I monitor now on coreg and sometimes its 130/ 90 which is not too bad never higher than that. Well thanks for your time Dr. Amanda

[JAMESFETT]

Your numbers sound quite good. The heart rates, resting and with exercise don't sound alarming. And your B.P. levels mentioned are not alarming either. In PPCM heart failure and IDCM heart failure, the beta blocker (BB) carvedilol (Coreg) is a much better medication than atenolol. Should you need it you can easily, working with your cardiologist, work up to higher dosages. At any time did you take ACE-inhibitors (ACE-I), such as lisinopril? That is perhaps the first choice in PPCM heart failure and BB a close second. Not saying that you need it now since you are in recovered range. I do encourage continuation of the BB for a full year from time of diagnosis to be sure the process is well-controlled and will not relapse.

JD

[AvaWegs1377]

Hi Dr I was never put on an ace ininhibiator just lopressor but hated the side effects of it so was switched to atenol, and now coreg. Just quickly shoould i stay away from alcohol ? I was at a wedding the other weekend and had a couple glasses of wine i was a tipsy but the next morning my heart was racing . Its not a big deal for me but was wondering what i was feeling from the alcohol and meds combined? Also i was a healthy and active prior wit no heart conditions why did this happen is it a virus? My cardiologist just seems clueless. Also if i get pegnant again will it happen again. she said a 50/50 chance. I too scarred to try agaiin . THANK YOU, Amanda

[JAMESFETT]

Best estimate right now of risk for relapse of PPCM in a subsequent pregnancy for someone who has recovered from her PPCM is about 15 %. Would you like to look at my algorithm on the post-PPCM baby forum? With PPCM recovery I see no contraindication to taking a glass of wine or a beer a day; unless one has history of previous addiction to alcohol, in which case total abstenance is indicated. PPCM, by definition, only occurs in previously heart-healthy women. One (leading) hypothesis is that it starts with a viral infection and passes into an autoimmune myocarditis. Now that you are in a recovered EF range, there is no need to think about taking an ACE-inhibitor. Your only question will be how long to continue the Coreg before phase-out.

JD

[Stephanie'sbigheart]

I have noticed that when my BP is really low my HR is higher than normal. What is your BP?

[AvaWegs1377]

My blood pressure is quite normal never to low or too high. By the way what is SOB? Also you seem like your ef is back to normal. How do you feel ? we were dx around the same time.

[Stephanie'sbigheart]

SOB = Shortness of breath.

[Stephanie'sbigheart]

Amanda,

Who are the other questions directed toward?

Thank you,

Stephanie