Elevated HR (especially during exercise) is seen quite often after Covid. You were sick one year ago!? That’s quite some time! Any other symptoms? What about the ectopics? How often? How do you feel them? Is it restricting your training?
Have you seen a cardiologist? ultrasound of the heart? bloodwork? ECG? ECG while exercising? …
again more questions than answers;-)
hope it helps anyway!
Elevated HR 12 months later
November 22, 2022 at 6:42 am #72799davelockyer101Participant
I’m not entirely sure this is a result of Covid but I’ve reliably tracked a raised HR of 15-20 bpm since Nov last year (Mainly trail running/hiking). I’ve also been diagnosed with ectopics as I started getting flutters at the same time. Wondering if anyone else has had long term elevated heart rates and how best to resolve this. It’s meant that I’m a Zone above what would normally be expected in all my training. I’ve tried to spend time focusing on Z1 training but there doesn’t seem to be any adaptation. It feels like my heart is super sensitive with an increase n effort resulting in elevated bpm compared to what I would typically see. Here’s a hr comparison at the same pace and on the same course, typical of what I’ve seen before and after this happened.
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Thomas Summer, MD on November 23, 2022 at 2:26 am #72814
Hi Dave!davelockyer101 on November 23, 2022 at 10:21 am #72827
I’m not sure if I had Covid unless I was asymptomatic. The ectopics were happening several times a day to start with but are now less noticeable and mainly at bedtime when supine. I had an ECG which picked up the ectopics but nothing else and the echo cardiogram didn’t show anything physically wrong with the heart. Bloodwork hasn’t shown anything either. I was suffering from deep faitgue but this has improved a lot in the past month. I’m able to train OK but with my HR being a Zone above where it typically was and with no adaptation happening it means that at an easy pace I’m in upper Zone 2 when I would usually be in Zone 1. It’s all been very puzzling and I was hoping things would settle down but a year later there doesn’t seem to be any improvement. I could just forget about it and accept that my Zones have changed but I know there’s something not quite right which I’ve been trying to get to the bottom of. The doctors are reluctant to recommend further tests here in the UK and going private is very expensive….Thomas Summer, MD on November 24, 2022 at 3:28 am #72880
How much did you train in the last year? And before? Maybe overtraining is something to consider? Any other illnesses? Covid seems to be an unlikely cause, if you never had it;-) if you want to get totally sure about that you could do a blood test for antibodies.davelockyer101 on November 24, 2022 at 3:54 am #72882
Thanks for the interest. Last summer I built up to a fastpack challenge with most weeks at about 7-10 hrs of training on non peak weeks but also with quite a bit of work/life stress coming out of lockdown here in the UK. Looking back at the data, I think the issues started after a fastpack attempt in Sept which I abandonned with suspected Rhadbo (I think did an ME workout too soon before this with muscle damage still in the system). I felt unwell for a couple of weeks after this and the ectopics started roughly about the same time. I reduced my training and kept things really gentle, with a lot of hiking but looking back the heart rate became elevated around the same time. Stress wise things have really settled down and I’m back into about 5-7 hours of training each week but for some reason the heart rate still feels super sensitive to any increase in effort. If I did overdo it then could it still be elevated a year later and what can I do to bring it down?Thomas Summer, MD on November 24, 2022 at 7:29 am #72886
Overtraining is not the result of just one or two big efforts. But that can push you over the edge, if you were close before. It can take quite a while to get back to normal. How is your fatigue improving? You should really keep the intensity below AeT as long as you don’t feel truly healthy. Are you training anything else than endurance? Sometimes a change in the routine brings good improvements. I would also recommend to do a stress ECG while cycling, or running on the treadmill. Just to see if there is any problem when your heart is at it’s maximum.davelockyer101 on November 24, 2022 at 8:52 am #72893
Thanks. The fatigue has definitely improved in the last month and I feel OK healthwise apart from the occassional ectopics. Most of my training is below AeT most of the time anyway. I do a few progression workouts on the elliptical which take me above for the last 10-15 mins but everything else is endurance, although there’s a lot more at upper Zone 2 than usual due to the elevated HR. It’s pretty hard to get referred for any further test here and I’m considering buying an ECG device so I can check things out myself. Do you have any suggestions for how I could mix things up a bit. I don’t have any particular agenda over the winter apart from maintaining fitness and sprinkling in some functional strength training once a week…Thomas Summer, MD on November 28, 2022 at 3:44 am #73040
Some more playful things: climbing, dancing, ball games (tennis…) True endurance training only if you feel healthy and it don’t creates more than “normal” fatigue.
I wouldn’t recommend buying an ECG. Only if you can really read it and don’t drive yourself crazy with it;-)
Hi Dave, glad to read that you are doing a bit better. Are you doing any dietary, supplementation, or lifestyle measures to counteract systemic inflammation, to help your heart cope with the ongoing issue?
Why I ask: My situation is not idential to yours, but some of what I’ve experienced may give you some clues. I have not (knowingly) had COVID but 6 months ago I had a bad cardiac reaction to a ‘rona vax (spike protein version) which resulted in an immediate, high number of palpitations (landed in the ER the next night) that lasted for 5 months (and continue to this day with less frequency), and for a few weeks early on, constant chest pain and pressure. This did not result in a raised HR for me, however.
I did a full cardiac workup with shiny results, ie: no “heart disease” diagnosed. Here in the US, doctors are reluctant to even respond to a patient asking, “Can this be related to the vax?” (mine just gave me a blank stare and changed the subject). Despite the lack of a linking diagnosis, with a clean cardiac workup I’m convinced my overnight developments had to do with the vax; I suspect myocardial inflammation (that’s a longer convo… based on all my symptoms, etc.). I got zero help from the cardiologist, so I talked to the doc I work for, who treats patients who have systemic inflammatory disorders; he advised me to start on an assertive anti-inflammatory supplement regimen.
Due to an autoimmune condition that makes me prone to systemic inflammation, I’m already on a highly anti-inflammatory diet for my brain health (modified AIP + keto) but I feel that adding the supplemental support has really helped me over time to quell the systemic inflammation that periodically seems to bring on the palpitations. I use resveratrol and curcumin in combination (some of the research shows the combination is more effective than taking either one or the other alone), a high daily dose of fish oils (Omega 3 mainly — too much Omega 6 is actually inflammatory and most of us get plenty from diet anyhow), and liposomal glutathione/S-aceytl L-glutathione (those versions are better absorbed/utilized than the rest), which supports the anti-oxidant systems of the body.
Also, reducing or quitting caffeine majorly reduces my palpitations (not that I like doing it…). On a more daily basis ongoing, the caffeine feels like the biggest offender.
I’ve also found that a regular breathing practice (slow in-breath, slower out-breath) majorly slows my heart rate (I actually do pranayama, but I recommend to learn it properly from a teacher, as it can cause nervous system irritation if you do it incorrectly). Lots of research on slow, controlled breathing in relation to HRV and nervous system health.
Ironically, since shortly after the start of this, I have not have any issues while doing aerobic/anaerobic training; no palpitations during exertion, no pain or pressure during exercise except for one hard hike shortly after the vax. The palpitations occur mostly when I’m sitting at my desk, or as you mentioned, supine in bed. As I mentioned above, raised HR has not been a problem for me. My heart stayed inflamed for at least 5 months before it started to calm down. In the past 2 months, when I let my system get inflamed again (through stress, bad diet, etc.), the palpitations ramp up (but never during exercise… I’ll take it!).
Maybe you’ve tried all of this, but if not, you may want to run it by your healthcare practitioner and see what they say.davelockyer101 on January 30, 2023 at 1:00 pm #75219
Thanks for chipping in with your experience. In general, I’m continuing to see a raised HR compared to where I was 18 months ago but am back to training as I’m rarely getting into Zone 3/4 and I don’t have any symptoms when exercising (Am currntly using the 20 week Luk eNelson plan which seems to be going OK). It just means that quite a bit of what would have been Zone 1 training is now Zone 2. I’m still noticing the ectopics, usually when supine at night on my left side. I’m also monitoring HRV too. I have been back to the doctor but they are not willing to investigate any further. Very few health professionals here are willing to even begin a conevrsation about possible correlations to the v. Ideally I would like an MRI to check if there is any sign of damage as a result of iflamation but that won’t happen unless I pay for the scan. I’ve been taking Nattokinase as well NAC and do supplement with fish oil and magnesium as well as some curcumin. I might look into the possibility of reservatol also. Thanks again for the respnse and take care…Thomas Summer, MD on February 2, 2023 at 5:43 am #75300
Thank you for your story. Post vac Syndrom is a problem. Unfortunately not a lot of truly proven therapies. The supplements and strategies for overall healthy lifestyle are a good recommendation. I totally support that.
But why going so much in the direction of covid and vaccines here? Dave, as I understand it, there is nothing to assume that your symptoms are related to that?! Or am I missing something?
Interesting what you mention about getting more ectopics when laying on the L side. Perhaps this is standard, but the tech who did my heart ultrasound had a table with a little trap door that is opened when the pt lies on the L side — she said it allows the chest cavity to expand and allow the heart more room to beat without being squished against the L chest wall during the imaging. On ultrasound day, I was having chest pain and pressure, and when she opened that trap door I literally felt my heart ease up with the added room; it was a welcome relief. In the subsequent months, when I have more systemic inflammation (I have a bunch of cues to that), if I lay on my L side to sleep, my heart feels cramped, more “bumpy” (what I call it when I’m having palpitations) and I have to lay on my back or roll to the R side to sleep. I’ve been using it as a bit of a feedback loop; sometimes I notice the problem laying on my L side before I realize I’m generally inflamed, and it’s a memo for me to up my anti-inflammatory game.
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