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Forum Name: Cardiology Symptoms

Question: Sometimes hard to breathe after normal treadmill walk


 Nora C. - Mon Apr 06, 2009 1:34 pm

This morning I had breakfast (cereal w/ milk) and went upstairs about an hour after eating to do my newish exercise, walking on a manual treadmill. I started doing this in February for 3 weeks, did not do much in March and just picked it up again in April. I walk .5 to .75 miles at 1.5 to 2 mph at 1st incline level.
I quit smoking after 25 years in July and had a scare with a couple of panic attacks in late September that sent me to the ER and a cardiologist. My stress test was normal and ECG.
I am 46 and wear a wrist heart rate monitor. I am generally in the high 70s before and try to not go much above 122 as I was pretty sedentary for the last 10 years. I had been getting pretty confident because I wasn't having any trouble and then today with a heart rate around 120 about 14 minutes into my 20 minute walk I was sweating. I kept going because I thought with my heart rate okay it was possibly (sorry for this) I felt not right because I hadn't had my morning BM yet.
Normally after walking my heart rate goes down quickly to the 80s and did again today, but I felt slight discomfort in my chest, but not like a weight. More in the muscles on the inner part of my breasts.
I laid down and didn't really feel good again for at least an hour.
I am wondering if my pre-diabetic condition affects my new exercise and if I should have waited longer before exercising. I have some endometrial swelling and wonder if (about 4 days to period) this somehow affects my exercise if I haven't had a BM yet. Or what else could have caused this "not-right" feeling?
I wondered if maybe my blood pressure dropped or something.
Before the panic attacks in September I rode my bike outside for too long on 2 occasions and the first time I was great and the next week I had the same reaction riding the same distance. This is why I got the heart rate monitor.
I am 5'6", weight 150 and am 46. My blood pressure since quitting smoking is around 120/78 or 80 unless I am at the doctors where it shoots up. I have lost 10 pounds and am trying to lose 15 more to stop the possible diabetes.
Any insight you can give me is appreciated. I return to the cardiologist in the Autumn for a follow-up.
Thanks, Nora
 John Kenyon, CNA - Fri Apr 10, 2009 12:57 am

User avatar Hi Nora,

First let's sort out the various possible factors and non-factors. You have been diagnosed as pre-diabetic, meaning your fasting glucose has been, on at least two consecutive occasions, between 100 and 125. This won't affect anything much. You've also had some panic attacks fairly recently. This can cause a whole host of misleading symptoms which are quite real, but not especially telling. We should save this fact for future reference. You started your exercise program briefly in February, stopped after three weeks, then resumed recently. This could account for a lot of inconsistencies in your response to exercise. You also use some incline in addtion to a pretty conservative rate and distance. You smoked for 25 years, but have quit for almost nine months now and the panic attacks followed your early cessation of smoking. Your resting and working heart rates are both very reasonable and normal for conditions. You've had a normal stress test and resting EKG. Your recent disturbing episode followed not feeling right because of not having had the usual bowel movement. Your height and weight are within normal limits and yields a normal body mass index (BMI). Your primary complaint involves some mild, atypical chest discomfort following exercise, taking all the above into consideration.

So then: what does this look like? First impression would be likely anxiety-mediated chest discomfort related to inconsistent exercise program, long-term smoking history and possible lower GI bloating. Most likely this was innocent.

However: given your age, smoking history and inconsistency in exercise tolerance, my advice would be this: resume the exercise program, remove the incline for a while, and if this response should happen again, go to the ER directly, instead of lying down and resting first. Although I strongly suspect this is innocent, it's difficult to analyze symptoms alone in an adult woman, since heart disease symptoms often present atypically and prediabetes can actually represent metabolic syndrome in some cases. So while I think it's both ok and beneficial to resume the exercise program, if you have the same thing occur again under the same circumstances, it would be prudent to have yourself checked while this is happening. Chances are it will turn up nothing, but I don't believe in taking chances.

I hope this is helpful to you. Please follow up with us here as needed.

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