Chronotropic Incompetence: how are you managing it?
Basically a lofty sounding description of one's heart not being able to perform under load anymore for various reasons.
"Chronotropic incompetence (CI), broadly defined as the inability of the heart to increase its rate commensurate with increased activity or demand, is common in patients with cardiovascular disease, produces exercise intolerance which impairs quality-of-life, and is an independent predictor of major adverse cardiovascular events and overall mortality. However, the importance of CI is under-appreciated and CI is often overlooked in clinical practice. This may be due partly due to multiple definitions, the confounding effects of aging, medications, and the need for formal exercise testing for definitive diagnosis. "
I am dealing with this and the surprising thing is the relatively abrupt onset, at least in my case, in a matter of weeks at most. Suddenly your heart rate drops into the bradycardia range,
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Did you get any help with the questions you had? Your esophagus is very close to your heart. I've read of a man with an arrhythmia that was solved by slightly relocating his esophagus.
Another thing, has anyone considered the possibility of a Hiatial Hernia, where part of the stomach protrudes up through the opening in the diaphragm. This can be constant or sliding (comes and goes).
I've had chest discomfort even though the cardiologist there's nothing wrong with my heart
I'm grateful reading this topic that provides another lead in my attempt to make sense of my own long-standing tinnitus, recently emerged gastritis/heartburn and erratic blood pressure . My general health profile is good, but I've always been prone to stress/anxiety and it seems to have finally found a physical outlet. The common element is, apparently, the vagus nerve. My working hypothesis starts with the mild ear infection that apparently set off my tinnitus a year ago and possibly resulted in a minor physical change that sensitised it to activity in the vagus nerve, which among other things has (so I understand) a controlling influence on the production of acid in the stomach. The ear-vagus connection is recently established clinical science. In reflux, stomach acid can travel up to the ear and induce tinnitus, especially when a person sleeps, but my tinnitus declines to near silence after lying down for a while and increases in volume on waking and around mealtimes (in a Pavlovian way, it starts before I've taken a first bite). As for hypertension, there is research evidence that GERD can lead to it. When I described my sudden gastritis and severe reflux to my doctor, he referred me for a gastroscopy then took my blood pressure, upon which he nearly had kittens and on the spot prescribed a calcium channel blocker. He dismissed my suggestion that the hypertention was atypical and possibly connected to the gastritis (which was stressing me into the bargain), and is evidentally innocent of the fact (as I was at the time) that CCB's make reflux worse. I took one tablet and had a disturbing reaction, was advised by an emergency doctor to take no more, then learned this fact for myself. Meanwhile, pending my gastroscopy, I am self-treating the gastritis by following the standard GERD diet and behavior recommendations, dosing with temporary-relief antacids as needed, gastric-acid-neutralising lemon juice before meals, herbal teas or ginger with honey and aloe vera juice to dampen down inflammation and encourage healing of my hurting esophagus. After a lot of reading, I've put on order probiotics, kyolic and cannabidiol (for multiple reasons) and plan to avoid prescribed medicines unless h.pylori is found, in which case I anticipate my self-dosing to assist coping with the antibiotics.
PS. I'm much indebted to Mayo for advice on the GERD diet and much besides. It is my first port of call for medical facts, even as I cast my eye into less well-mapped seas.
I’ve had long covid for three years the small fiber neuropathy with dysautonomia variety. I diagnosed my own chronotropic incometence . The cardiologists were clueless because there is nothing wrong with my heart, its the autonomic nervous system which can’t tellmy heart to beat faster with exercise. It actually goes up to about 110, then drops to 75 and stays there until I pass out or stop. Its also called cardiac deceleration. It is easily picked up on a regular stress test, but they don’t normally monitor with a tracing the parameters that help to describe it. Just have blinders on looking for ischemia which does not exist. I don’t have bradycardia, just not enough increase as the muscles draw more oxygen out of the blood, it doesnt either get to the brain or the signal doesnt get from the brain to the heart and lungs. I also dont increase my breathing naturally, so get extremely short of breath and the pulse ox goes from 98 to 90%.
A separate short circuit is the circulation to the legs. Instead of the vessels to the leg muscles dilating, mine seem to constrict as my legs suddenly ‘ turn to jelly ‘ at a certain point in exercise.
As time goes on some of the nerves have seemed to heal and work almost normally. But I still reach a limit with the heart rate.
Wondering if anyone has been diagnosed with this?
If so, how are you exercising and what type of diet restrictions?
Hi @ffud, welcome. Good question about managing chronotropic incompetence with diet and exercise.
I moved your question to this existing discussion of the same name here:
– Chronotropic Incompetence: how are you managing it? https://connect.mayoclinic.org/discussion/chronotropic-incompetence/
I did this so you can read through previous helpful posts and easily connect with members like @mleitnaker @soliloquized @mayo33 @exboater @cai and more.
@ffud, how long have you been dealing with chronotropic incompetence? What helps?