This One is Interesting!

Hello PMC!

I hope you are all doing well! I have something interesting to share with all of you and hopefully you can provide some feedback. I will start by saying that I have an appointment 6/9/22 with my Cardiologist to discuss same. I've been experiencing leg weakness daily and sometimes my thighs burn when I walk as if I was doing intense exercise at the gym. I've noticed that my legs (thighs mostly) have trouble doing anything really demanding. Examples of these demanding exercises would be stairs, squats, or anything that is more of a dynamic exercise.

At work I have 4 flights of stairs from top to bottom. I can do 2.5 flights relatively easy, but by the third my heart rate is going too fast, my legs are burning and I feel the presyncope sensation coming so I stop to catch my breath. I have not fainted but it does leave me feeling awful afterward all over my body (but mostly in my chest) for about 20-30 mins. To give you some reference my heart rate when I begin is around 65 BPM and will get to around 135-140 BPM by the time I stop. I've had a CT Angiogram, numerous stress echo's (most recent 4/19/22), regular echo's and even a Cardiopulmonary Exercise Test. All of which for the most part were completely normal. I can't understand why this is happening. Now here's the kicker....

I recalled during my last business trip that when I wore compression socks they really helped me. I didn't feel much leg fatigue and there were quite a few stairs I had to tackle here and there. Long story short I decided to wear compression socks today and try the stairs at work. I was able to do 3 flights of stairs without incident. What I found odd was that my heart rate was not going as fast as it did when I was not wearing compression socks. It only maxed out at 116 BPM from around 65 BPM baseline. I could actually feel it sort of pounding harder, not faster. From there I let myself get back to baseline and I repeated the test and got the same results. My heart rate did not even hit 120 BPM! Yet again I felt like it was struggling rather than pumping fast like before. 

I'll end this by saying I recently had an Ankle Brachial Pressure Index Test with Doppler which was completely normal. I've also had a Pulmonary Function Test (Feb 2022) that was normal too. I am stumped. Like I said I have an appointment with the Cardiologist but I feel it will just be more of the same. They think because all of their standard tests come back normal that nothing is wrong with me. I've been dealing with this now for a long time and still have not received a complete diagnosis. I live in Los Angeles California and have seen doctors at the VA and outside using my private health insurance. Anyhow that is my rant for the day. Thank you for listening and I'm open to any suggestions or hypothesis. All the best! 



Stair intolerance

by Julros - 2022-05-10 11:16:03

Hi Alejandro, It sounds like you've had a lot of tests with good results, but unfortunately still have a challenge on stairs. I am making a wild guess, but I wonder about venous insufficiency and or right-sided heart failure. Perhaps you are not getting enough blood return back to your heart and or into your lungs, resulting in not enough blood to the lungs or a lowered BP. Compression socks can certainly help. Right sided heart pressures are not always assessed with other cardiac tests. 

I would recommend continuing with the compression stockings if they help. I will be curious to know what your cardiologist has to say. 

Never give up your search for answers

by Gemita - 2022-05-11 11:23:04

Dear Alejandro, many would by now perhaps have stopped their activities if they had the symptoms you describe.  It must be so exhausting.  We will come up with an answer for your symptoms, I feel sure about that. Don’t push too hard though to achieve your exercise goals.  Your symptoms may be the body’s way of warning you to hold back, to pace yourself better? 

Have you had a Lactic Acid Blood test to check for a cause for your tired, burning muscles and other symptoms?  That is one thought.  Another thought, have you had Covid and are you still experiencing long Covid symptoms or something similar due to a viral or chronic low grade bacterial infection.  

Abnormal lactic acid levels can lead to, and be caused by many health conditions which can upset our body’s pH balance.  My husband has experienced lactic acid abnormalities on a few occasions and has been very poorly with this, requiring hospitalisation and correction with intravenous fluids + insulin and bicarbonates.  Over breathing (hyperventilation) has also been another trigger for him causing respiratory alkalosis.  Of course abnormal lactic acid levels could occur with a number of conditions like an infection, heart/lung problems, severe anaemia and other causes, including medication.  Hopefully your general doctor will get to the bottom of your symptoms for you too, but keep up the pressure.  You deserve an answer.  

When you were tested, perhaps you were not completely symptomatic at the time of testing.  Symptoms can be intermittent.  Your tests might be fine because on the whole you are physically fit and can still compensate for any problems you may be experiencing.  Why is the body so good at hiding an illness, I ask myself and I am sure you do too?  Were you better before or after your pacemaker I wonder?  Is there a link?  So many unanswered questions but your mounting symptoms should give vital clues now, surely?

Alejandro, as always I hope for the very best for you and that your forthcoming cardiology appointment will be helpful

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In fact after the final "tweaks" of my pacemaker programming at the one year check up it is working so well that I forget I have it.