TMBRA - Rider Board

[Anonymous]

Doc
I had some what I call fluttering with my heart. I normally ride 10-12 hrs/wk. Mon I had an elevated HR during my ride, really elevated for me 170-178 bpm, I had to back off and just chalk it up as a bad day. Yesterday I rode the same ride and HR stayed between 155-158. Again I chalked Mon up as a bad day, stress etc. While taking my resting HR last night I noticed a skip in my pulse. After taking an ekg with a paramedic buddy of mine, my heart is not skipping, it's firing too quick on top, then a pause, hence the PVC. I have an appointment with my doctor on Mon. He's out of town until then. My question is: I have a 100 mile ride planned for Sat on the road bike. It's not a race or a tour but just a bunch of us going as a group as training for the Hotter n Hell. Pace will be around 16 mph. How cautious should I be about going before I see my doc? Can I monitor my HR and pull out if I don;t feel well? Should I skip it all together and wait to see my doc?
Thanks
Brent

[The Bike Doc]

Brent:

The cautious route of waiting to see your doctor is the safest route. Without a look at your EKG, a thorough history and physical exam, I cannot give you any other advise.

With that said, I am also a logical physician. Your max heart rate was 178 when you did the ride last week. A heart rate of 178 in and of itself is not necessarily dangerous especially if is an expected elevation due to the conditions you were riding in (heat, humidity, hydration status, over training or undertraining, work load). You have been bicycle riding for a while and it is likely that you have been progressively conditioning yourself. It is unlikely that you suddenly have developed a serious irregular heart beat (an arhythmia or better termed dysrhythmia) without something else have going on with your heart such as a heart attack or an infection (myocarditis or endocarditis). Again, here is were a detailed history and physical exam would be beneficial.

The Hotter than Hell Hundred is still several weeks off so you will have plenty of time to get in a long training ride before the event. So lacking a detailed history, physical and review of your EKG, I still would advise you to wait until you see your doctor. Let me know how it comes out.

Thanks,
_________________
Paul K. Nolan, MD
AKA: The Bike Doc