I feel like I am having heart attacks when I work out. Am I going to die?

February 28, 2009 9:29 AM

I am a young guy and I feel like I am having heart attacks when I work out. Am I going to die?

When I do strong cardio exercise I always tire very quickly. Jogging a few hundred feet will cause me to cough and try to catch my breath for 10 minutes. It has been this way all my life, even when i trained athletically for hours per day. Doctors said I was too young to have a heart problem, yet when I saw a cardiologist he said I have a prolapsed mitral valve and heart arrhythmia, but didn't want to diagnose mitral valve prolapse syndrom because he didn't believe in it. Yet he was not able to reproduce my heart issues because his stress test was gradual, not stop to hard exercise like reality.

Is there a way I can discover what is causing this extreme fatigue? I want to be normal, I want to exercise, I want to be able to run a mile. I get winded just walking up stairs. That isn't normal for a guy in his 20s, and it doesn't seem legitimate that a doctor can't find a cause unless he is incompetent.

My symptoms are, under normal cardiac exertion, palpitations, constricted breathing, chest pain, blackouts, tunnelvision, coughing, extreme muscle fatigue. No history of heart disease, no smoking, no drinking, no bad habits or exposures. Doesn't happen at rest. When i work out real hard, it feels like I am having a heart attack. What could this be? Why can't it be reproduced by a gradual stress test? How concerened should I be?

posted by torpark to health & fitness (22 comments total)

have you considered asthma?
posted by wocka wocka wocka at 9:35 AM on February 28

Don't think it is athsma. Doctors said it wasn't athsma either. I don't get this when I am anxious. I breath deep and very well at all times. Inhailers do nothing, adrenaline does nothing, doesn't seem to be bronchial.
posted by torpark at 9:38 AM on February 28

Have you ever worn a heart rate monitor? If so, what kind of heart rate range are you at when you start to experience serious pain/problems?
posted by csimpkins at 9:44 AM on February 28

You need a new cardiologist. Take a nuclear stress test and watch the blood flow.
posted by JohnnyGunn at 9:47 AM on February 28 [3 favorites]

Not to understate what could very well be a medical problem... but from some of your comments, it sounds like you might just be working out way too hard.

Yet he was not able to reproduce my heart issues because his stress test was gradual, not stop to hard exercise like reality.

When i work out real hard, it feels like I am having a heart attack.

Unless your pretty well trained, you shouldn't really be exerting yourself too hard. And certainly not without a gradual warm-up.

A lot of people think that being able to run a mile means they have to give it their all and push through pain. That's just not the case. Any reasonably healthy person should be able to run a mile without feeling like they're going to explode... as long as you take it easy. Working out doesn't mean pushing yourself until you have a heart attack.
posted by csimpkins at 9:51 AM on February 28

his stress test was gradual, not stop to hard exercise like reality.

You shouldn't be going from a dead stop to hard exercise, particularly if you're inexperienced/unfit. If you didn't have any problems with the gradual ramp-up of a stress test then maybe your problem is just that you're pushing too hard too fast without a proper warm-up.

That being said, you should try to get a second opinion from a cardiologist who doesn't ignore potential diagnoses because he "doesn't believe in" the conditions.
posted by missmagenta at 9:52 AM on February 28

Jogging a couple hundred feet shouldn't cause me to collapse in pain. That isn't over-exertion. I achieved top physical condition through training over years, and still had that issue as a young boy, so I don't think it is just working too hard, as it happens when i work mildly for a short amount of time.
posted by torpark at 9:54 AM on February 28

Go to a different doctor. Tell him all of this. If he doesn't take you seriously, go to another one. Do this until someone lets you show them what happens to you when you work out.

I had a cardiologist who had me bring in my trumpet and play it after doing a stress test to recreate my problem situations while they did an ultrasound. We actually watched the air bubbles go the wrong way in my heart as I played. There were other examples of how they worked with me to figure out what was going on in my specific situation, but it made me feel like they were really doing their job.

...didn't want to diagnose mitral valve prolapse syndrom because he didn't believe in it.

Also, this scares the crap out of me. Please go see another doctor. Heart stuff is nothing to mess with. Take it from another twenty-something - go get it figured it out.
posted by Kimothy at 9:57 AM on February 28 [1 favorite]

Definitely go to another doctor. My cardiologist hooked me up to a Holter monitor, which is a portable monitor you wear all day. It records your heart all day; you press a button on it when you have symptoms to help the doctor see what's going on. If you were wearing one of those and did your normal workout, you'd at least have some sort of record.

I have an arrhythmia that occasionally gives me symptoms similar to what you're experiencing, but my symptoms aren't as bad. Definitely find another cardio person.
posted by PatoPata at 10:25 AM on February 28

Jogging a couple hundred feet shouldn't cause me to collapse in pain. That isn't over-exertion.

Perhaps it shouldn't be, but for you it evidently is. Maybe you need a different warmup ramp than other people. I understand you're frustrated by not being able to do what other people do, but perhaps you simply need to customize your exercise routine for your own particular needs instead of just pushing it and then getting upset with the results.

For god's sake go get another cardiologist's opinion. The symptoms you describe are alarming at best. You shouldn't be flirting with them. I am really concerned for your safety after reading this.
posted by scarabic at 10:28 AM on February 28

You need to see another doctor. This could be something really, really serious, like pulmonary hypertension, or any number of potentially fatal things.
posted by peggynature at 10:30 AM on February 28

Nthing find a second doctor, and a third. I don't understand why people are giving you shit and assuming you are exercising wrong, frankly...find a new doctor and then worry about your exercise technique.
posted by dubitable at 10:31 AM on February 28

I agree that if you can reproduce your symptoms with any predictability, you should not blow this off until you've had an assessment of your heart with active symptoms. Chances are it may well be nothing, but you need adequate peace of mind if nothing else, and you won't get that until a doctor has evaluated you with active symptoms. Probably the easiest way might well be holter as others have suggested, or even repeating an in clinic stress test but with your own pace and not the typical protocol they use.
posted by drpynchon at 10:37 AM on February 28

Nthing the "get a second opinion" suggestion.

There are many things it could be; heart stuff, GERD (reflux), and asthma-related lung issues. These things can all manifest with similar symptoms. Find a doctor that believes you and will thoroughly evaluate you.
posted by answergrape at 11:08 AM on February 28

I agree with people above that this sounds alarming. After getting a second/third doctor's opinion, you may want to try the following experiments:

- standard workout after a day of steady light stretching and heavy hydration
- standard workout after a day of normal hydration without solid food
- 6 weeks of weekly meditation classes. then standard workout after warming up with 15 minutes of meditation
- a prolonged many-hour stress test with a doctor present.

Each of the above has a significant impact on how I perceive the state of my heart and breathing.
posted by metasj at 11:31 AM on February 28

That isn't normal for a guy in his 20s, and it doesn't seem legitimate that a doctor can't find a cause unless he is incompetent.

I mean, that seems to be the consensus, doesn't it?


You could look at this.

And this

It looks like other people believe in mitral valve prolapse. The again, maybe you're having panic attacks.

The bottom line is you need to see another doctor--nobody's qualified to talk about your heart over the internet, and that guy sounds annoyingly uninterested in figuring out your problem.
posted by A Terrible Llama at 11:49 AM on February 28

I didn't see it mentioned above, but I would cease exercising in the way that brings on the symptoms until you get that second opinion. Just do very light cardio if you feel you have to do something.
posted by vincele at 11:50 AM on February 28

What you're describing are also classic symptoms of congestive heart failure. Please get to a cardiologist ASAP.

Doctors said I was too young to have a heart problem

What backwoods crackhead doctor said this? People are born with heart problems. Children develop them. This is insane.
posted by xmutex at 1:10 PM on February 28

New doctor. I have congestive heart failure, which was only diagnosed after about six months and as many doctors, variously telling me bronchitis, asthma, and "huh, maybe it's your thyroid". I was 24 years old at the time, and I was near death when my endocrinologist sent me to the hospital and told me to tell them something was wrong with my heart. Even in the ER, even with the report that the doctor thought it was my heart, they still tried to treat it as the flu, food poisoning, or a drug overdose. The several-month delay in diagnosis caused permanent damage to my heart and I will never be "normal" again.
Don't exercise, don't overhydrate, and keep hitting cardiologists until you find one that will work with you to determine what's wrong and help you treat it. Hopefully it's something relatively simple, but clearly your current doc is not getting the job done.
posted by katemonster at 2:33 PM on February 28

How did you get into top physical condition with this problem? I mean, the very opposite of being in top physical condition is tiring easily.

That said, do what everyone else says and get a new doctor.
posted by schroedinger at 2:56 PM on February 28

Doctors said I was too young to have a heart problem

What backwoods crackhead doctor said this? People are born with heart problems. Children develop them. This is insane.


I was told the same thing when I came home from college and needed a doctor I could see while I was away from school. Both doctors either said, "I usually only see old men here," or "You're awfully young to be here, don't you think?"

This was before we were even close to a solid diagnosis mind you, but it's infuriating after a while. Unfortunately it's more common than you might think.


How did you get into top physical condition with this problem?


I personally, have never considered myself in top condition, but I was in pretty good shape, and had been doing what I was doing for nearly 10 years before I started noticing symptoms and having real problems from a previously unknown birth defect.

Our bodies are weird. Strangely resilient in some situations, and then the smallest thing can break the dam. You never know when some underlying condition is going to rear it's ugly head. Isn't that why insurance companies require a battery of tests and labs before you can get full coverage?

Anyway, Torpark, it seems the general consensus here is for you to find a new doctor until you find one that really works with you. Best of luck.
posted by Kimothy at 8:24 AM on March 1

...didn't want to diagnose mitral valve prolapse syndrom because he didn't believe in it.

Oh, that's such bull. It's very real. Everything you described sounds exactly like what I go through when I exercise too hard -- and I have the very condition that your doctor chooses not to believe in. Get a new cardiologist and, in the meantime, don't overexert yourself.
posted by phatkitten at 10:12 AM on March 2