As I’m engaging in some heavy exercise, like shoveling snow, I’ll sit down every once and awhile to rest. As I’m sitting there my heart’s pounding normally, I’m sweating, breathing hard etc. (Nothing crazy either, I know my limits) BUT I feel fine. No pains or pressure in my chest around my heart, no funny feeling in my left arm, etc. My opinion is that tells me I’ve got no blockages anywhere. If I did, I would think when the heart is at its max pumping blood you’d feel pain at the points of constriction. Any medical folks here that can weigh in? (I’m 50 if that matters)
good question, at 58, I’m hoping someone answers.
Although I’ve had issues with tingling in my arm related to muscle build up during periods of heavy work (carpentry and all that) for decades.
You might try looking for websites that answer medical questions. I know that AARP and/or United Health Care Insurance have one.
Occam
party pooper
Hey, with the variety of members here, I’d be afraid that someone would suggest a thirty day prayer fast as the solution.
For example, I figured you’d blame the tingling in your arm on global climate change. :lol:
Occam
Well I know I have at least one constriction, and that’s to my head! After I posted I realized I had a Drs appointment coming up. I asked her and she in fact confirmed what I thought. If you have blockages in the 60% range, i.e. 60% blocked off in a vein or artery, chances are you would in fact feel pain on heavy exertion. Since I didn’t feel any pain at all she said that’s a very good sign that things are relatively clear. Obviously you can be below that threshold, like 20%, and not feel pain or pressure so don’t take lack of pain for granted. But all in all it’s a good sign.
ouch, that’s below the belt
While its good that you have no chest pain when you exercise vigorously it is by no means proof that everything is OK. Doing strenuous exercise without chest pain does not mean you can’t have coronary artery disease or be at risk for a heart attack.
Its important to understand that most people who have heart attacks do not have blockages that have gradually grown over time to occlude an artery. While that does happen sometimes and those people often have a history of exercise induced chest discomfort or other exercise induced cardiac symptoms like nausea, shortness of breath etc, that only accounts for 15-20% of cases. The other 80-85% of heart attacks occur in people who may have a relatively small (30%) occlusion without any exertional symptoms.
In these cases the person may exercise vigorously with no discomfort at all and then have a sudden heart attack without warning when they are doing nothing strenuous at all. The reason for this is that the plaque ( which is a complex structure with a cholesterol core and an outer layer of cells) may be unstable causing it to rupture.
The rupture then triggers the clotting cascade which results in the formation of a clot at the site occluding the remaining portion of the artery and resulting in a heart attack. These patients often have no symptoms at all prior to the heart attack because their occlusion was relatively small
Knowing nothing about your medical history, its always a good idea to see your doctor before taking on an exercise program for the first time. If he gives you the OK you should then begin a graduated exercise program to slowly build up your endurance. A rapid heart beat after shoveling snow may be evidence that you have poor exercise tolerance and would benefit from a regular exercise routine before another season of snow shoveling. As mentioned above though, always talk to your doctor first to make sure its safe for you to do this.
While its good that you have no chest pain when you exercise vigorously it is by no means proof that everything is OK. Doing strenuous exercise without chest pain does not mean you can't have coronary artery disease or be at risk for a heart attack. Its important to understand that most people who have heart attacks do not have blockages that have gradually grown over time to occlude an artery. While that does happen sometimes and those people often have a history of exercise induced chest discomfort or other exercise induced cardiac symptoms like nausea, shortness of breath etc, that only accounts for 15-20% of cases. The other 80-85% of heart attacks occur in people who may have a relatively small (30%) occlusion without any exertional symptoms.This makes me wonder that if it were possible to remove at least some cholesterol from blood, would it be possible to do a complete autologous transfusion, filtering all of the blood? If this were possible it seems to me that it would go a long way toward preventing plaque buildup, wouldn't it? If successful it could be done regularly, depending on the need, maybe reducing the need for stents and bypasses.In these cases the person may exercise vigorously with no discomfort at all and then have a sudden heart attack without warning when they are doing nothing strenuous at all. The reason for this is that the plaque ( which is a complex structure with a cholesterol core and an outer layer of cells) may be unstable causing it to rupture.
The rupture then triggers the clotting cascade which results in the formation of a clot at the site occluding the remaining portion of the artery and resulting in a heart attack. These patients often have no symptoms at all prior to the heart attack because their occlusion was relatively small
Knowing nothing about your medical history, its always a good idea to see your doctor before taking on an exercise program for the first time. If he gives you the OK you should then begin a graduated exercise program to slowly build up your endurance. A rapid heart beat after shoveling snow may be evidence that you have poor exercise tolerance and would benefit from a regular exercise routine before another season of snow shoveling. As mentioned above though, always talk to your doctor first to make sure its safe for you to do this.
I seem to recall an article about sixty years ago. When the Nazi internment camp survivers were liberated, the allied doctors gave them all examinations and treated their problems. Since they had been given the minimum amount of food, they were all extremely underweight. The doctors found that even the prisoners who had been overweight and with cardiac problems now had very clean arteries. Apparently when one is starving one’s body will extract calories from anywhere including stripping the plaque from arteries.
Occam
This makes me wonder that if it were possible to remove at least some cholesterol from blood, would it be possible to do a complete autologous transfusion, filtering all of the blood? If this were possible it seems to me that it would go a long way toward preventing plaque buildup, wouldn't it? If successful it could be done regularly, depending on the need, maybe reducing the need for stents and bypasses.Its not that simple. First of all doing an auto transfusion or plasmapheresis which would be more logical, is no simple task. It requires expensive equipment and highly trained staff. There is always a risk of infection as well as unintended fluid shifts which can be very stressful for the heart, and the effect would likely be temporary meaning this would have to be repeated periodically with these associated risks on each occasion. Additionally the problem of cardiovascular disease is not simply a problem of high cholesterol. Statin drugs reduce your risk of heart disease but not entirely by the method most people think. Yes they do lower cholesterol and this probably reduces risk to some extent but they also are vascular anti-inflammatories. This means they reduce the inflammation in the arterial walls that would otherwise promote the development of plaque and also result in more unstable plaques. We know this because if you use other cholesterol lowering drugs and reduce the LDL ( bad) cholesterol to the same level as with a statin you don't reduce cardiac risk to the same degree. The statins are doing something besides lowering cholesterol and there are a number of markers that show that secret lies in their ability to reduce inflammation. So doing some sort of plasma exchange or plasmapheresis would likely expose a patient to much more risk than taking a daily dose of a statin while providing less benefit.
This makes me wonder that if it were possible to remove at least some cholesterol from blood, would it be possible to do a complete autologous transfusion, filtering all of the blood? If this were possible it seems to me that it would go a long way toward preventing plaque buildup, wouldn't it? If successful it could be done regularly, depending on the need, maybe reducing the need for stents and bypasses.Its not that simple. First of all doing an auto transfusion or plasmapheresis which would be more logical, is no simple task. It requires expensive equipment and highly trained staff. There is always a risk of infection as well as unintended fluid shifts which can be very stressful for the heart, and the effect would likely be temporary meaning this would have to be repeated periodically with these associated risks on each occasion. Additionally the problem of cardiovascular disease is not simply a problem of high cholesterol. Statin drugs reduce your risk of heart disease but not entirely by the method most people think. Yes they do lower cholesterol and this probably reduces risk to some extent but they also are vascular anti-inflammatories. This means they reduce the inflammation in the arterial walls that would otherwise promote the development of plaque and also result in more unstable plaques. We know this because if you use other cholesterol lowering drugs and reduce the LDL ( bad) cholesterol to the same level as with a statin you don't reduce cardiac risk to the same degree. The statins are doing something besides lowering cholesterol and there are a number of markers that show that secret lies in their ability to reduce inflammation. So doing some sort of plasma exchange or plasmapheresis would likely expose a patient to much more risk than taking a daily dose of a statin while providing less benefit. I'm sure you know more about it than I do, but what of those of us who can't tolerate statins, I am one of them. My doctor has tried many types and brands. Statins almost immobilize me with muscle pain and I know I am not alone. Even a reduced dose does not get rid of the reaction. Lois
I'm sure you know more about it than I do, but what of those of us who can't tolerate statins, I am one of them. My doctor has tried many types and brands. Statins almost immobilize me with muscle pain and I know I am not alone. Even a reduced dose does not get rid of the reaction. LoisThe problem you are referring to is called Statin-Associated Myopathy and is a common problem without an easy solution. There is a good review article here on this subject: http://content.onlinejacc.org/article.aspx?articleid=1138253 Some doctors recommend Co-enzyme Q10 but as with most herbal and nutritional supplements there are no good safety trials and limited data on efficacy. Although the anti-inflammatory effect of statins is important there is still benefit to lowering cholesterol levels and there are other classes of cholesterol lowering drugs that are not associated with the same muscle side effects. You could ask your doctor about those. Diet of course is also helpful. You may also want to ask your doctor if you need treatment at all. New guidelines came out a couple of months ago concerning the use of statins. Some people who previously would not have been treated are now candidates for treatment but others who would have been on medication before are no longer advised to be treated. This article goes over the new guidelines but its a bit long so you may want to just discuss this with your doctor: http://circ.ahajournals.org/content/early/2013/11/11/01.cir.0000437738.63853.7a.full.pdf Basically the indications for statin usage are: 1) All diabetics regardless of their LDL level 2) All patients with a history of prior heart attack 3) All patients with an LDL over 190 4) All patients with a calculated cardiovascular risk of 7.5% or greater - see cardiovascular risk calculator here: https://www.heart.org/gglRisk/main_en_US.html
I'm sure you know more about it than I do, but what of those of us who can't tolerate statins, I am one of them. My doctor has tried many types and brands. Statins almost immobilize me with muscle pain and I know I am not alone. Even a reduced dose does not get rid of the reaction. LoisThe problem you are referring to is called Statin-Associated Myopathy and is a common problem without an easy solution. There is a good review article here on this subject: http://content.onlinejacc.org/article.aspx?articleid=1138253 Some doctors recommend Co-enzyme Q10 but as with most herbal and nutritional supplements there are no good safety trials and limited data on efficacy. Although the anti-inflammatory effect of statins is important there is still benefit to lowering cholesterol levels and there are other classes of cholesterol lowering drugs that are not associated with the same muscle side effects. You could ask your doctor about those. Diet of course is also helpful. You may also want to ask your doctor if you need treatment at all. New guidelines came out a couple of months ago concerning the use of statins. Some people who previously would not have been treated are now candidates for treatment but others who would have been on medication before are no longer advised to be treated. This article goes over the new guidelines but its a bit long so you may want to just discuss this with your doctor: http://circ.ahajournals.org/content/early/2013/11/11/01.cir.0000437738.63853.7a.full.pdf Basically the indications for statin usage are: 1) All diabetics regardless of their LDL level 2) All patients with a history of prior heart attack 3) All patients with an LDL over 190 4) All patients with a calculated cardiovascular risk of 7.5% or greater - see cardiovascular risk calculator here: https://www.heart.org/gglRisk/main_en_US.html Thanks, doc. I'll look into those websites. Lois
I’m with you, Lois. My cardiologist ran me through most of them, finally one that had only a tiny level of statin in it. It took a week for it to start with the severe muscle pains so I stopped that too. That was about six months ago, and it sat in my medicine cabinet. Then I got a bright idea. If it takes a week to hit, I could just take one every week or two, and get at least a little benefit. Ha, that damned stuff didn’t wait a week, the next morning I woke to my legs aching.
Occam
MacGyver - thanks so much for taking the time to share your knowledge. Unfortunately I’m a hard core Secular Humanist who’d rather know the facts, like you provided, than live with a feel-good explanation like I gave above. So thanks for ruining my day! 
So does regular exercise reduce plaque or strengthen the area that might otherwise rupture? It seems the answer would be no, you can’t get “better” you can only slow down getting worse.
I’m no doctor, but if you are shoveling my experience in the foundry taught me to be sure to bend my knees to avoid back problems. Also knee bends help the back.
MacGyver - thanks so much for taking the time to share your knowledge. Unfortunately I'm a hard core Secular Humanist who'd rather know the facts, like you provided, than live with a feel-good explanation like I gave above. So thanks for ruining my day! :) So does regular exercise reduce plaque or strengthen the area that might otherwise rupture? It seems the answer would be no, you can't get "better" you can only slow down getting worse.We dont really know for sure but there is some evidence that exercise reduces inflammation and may stabilize certain plaques or even cause them to regress a bit. Plaques are not unchangeable structures. As mentioned above not all plaques are created equal. Some are solid stable structures and others are very unstable structures. The unstable ones may have larger lipid (cholesterol) cores and these do seem to be the ones most likely to regress if for example a patient is treated with cholesterol lowering medication. Interventions may cause them to decrease in size or become less inflamed, more stable, and less likely to rupture. Here are a few articles on the subject if you would like to do some reading. http://circ.ahajournals.org/content/87/6/1781.short http://journals.lww.com/epidem/Abstract/2002/09000/Does_Exercise_Reduce_Inflammation__Physical.12.aspx https://circ.ahajournals.org/content/104/3/365.full http://www.sciencedirect.com/science/article/pii/S0021915005004545
Hey Mac and all, just to let you guys know This post pretty much saved my life. I’ve been feeling pretty fatigued lately and Friday night I woke up with discomfort in my biceps and across my chest and it didn’t go away. My wife called 911 and they took me directly to the cardiac hospital where I had a heartattack on the table. They put in a balloon and then four bypasses, two of which were blocked over 90%.the others were over 60% reading everyone’s posts alerted me to be potential danger so when it hit I didn’t hesitate. I’m recovering in the hospital, my wife brought my I-pad. Once again, thanks to all for this post. Now I’m officially off Te Appalachian diet.
Cap’t Jack
Glad to hear you are on the mend TVA. The Appalachian diet huh? I’ve never heard of that one before but I’m guessing it’s the polar opposite of the Mediterranean diet. Never hurts to have a good sense of humor when you’re recovering. Best wishes.