Expert sports cardiologist - Exercise induced vasodepression?

Posted by carpediemeu @carpediemeu, Jan 9 3:48pm

I will try and keep this brief, for 2 years I have not been able to do the sports/particular exercise I've done for 30 years regularly - weight training, judo and rowing machine.

2 years ago, I had a bp/hypertension scare and took myself to the hospital and now on amlodipine and ramipril at the age of 50 (never been on BP meds before always borderline).

Initially the hospital blamed my weight - so I lost 20kgs in 3 months (gave up weight training, 4 litres of water a day, 10,000 steps a day and intermittent fasting) and it made no difference to my blood pressure... turns out I have hereditary hypertension... my bp is now currently approximately 130/80 with medication..

Moving on, when I do judo now, weight training or go on the rowing machine... my head feels "fuzzy" after doing these particular exercises and I don't feel right for sometime - I have given up for now doing these sports/exercises due to feeling "fuzzy" afterwards..
However, I can play football (soccer), swim and walk fine.

I have had multiple ECGs, multiple stress tests (completed tests fine didn't stop early), MRI done on my heart, blood tests, and every other test I can think of - only thing flagged was my Aorta was thicker, and my 1st cardiologist coudn't help me any further explaining why my head feels "fuzzy".

As I couldn't get the answers I needed from that cardiologist, I looked searched for a sports cardiologist, and have seen them - but I have been waiting on their report (3 months chasing report extremely busy in demand sports cardiologist) to come back to me to conclusively diagnose what my issues are/might be - they said I might have "exercise induced vasodepression" and potentially this could be managed by maybe adding a beta blocker and changing my medication amlodipine & ramipril but they needed me to re do ECGS and exercise stress tests which I have done and waiting for them to review...

As I can't/don't want to wait any longer I would like to know if anyone knows of a subject matter expert anywhere in the world who I could forward on my medical notes/tests to, to review and potentially diagnose "exercise induced vasodepression" seems to be quite rare/my symptoms as my patience has run out trying to get answers.

Also I read somewhere that a tilt table test might be worth doing - has anyone had any experience of this as I have not done this test yet.

If anyone anywhere can provide any links, recommendations/pointers I would sincerely appreciate it.

Many thanks in advance

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Janell, Volunteer Mentor | @jlharsh | Jan 21 7:45pm

Hi @carpediemeu, and welcome to Connect. It must be difficult to quit doing the activities you’ve enjoyed as you wait for answers than explain why you get so fuzzy headed when you do them.

You mention getting a tilt table test so I searched from the Connect home page to find related discussion. You may want to review them as you continue waiting for others to comment. I notice they are located in a variety of support groups.
- Connect ‘tilt table’ discussions: https://connect.mayoclinic.org/search/

I am not sure where your cardiologists are located. I am a patient at Mayo Clinic and would highly recommend them. You can contact them here: http://mayocl.in/1mtmR63

You mention figuring out your hypertension is hereditary. How did you figure this out? Have you heard from your latest cardiologist with their report?

carpediemeu | @carpediemeu | Mar 27 3:26pm

Hi @jlharsh - many thanks for your kind reply, I am sorry I have not replied sooner as I've been trying everything/and anything to make progress and waiting to catch up with the extremely busy sports cardiologist...

Good news : -

1.) 6 weeks ago - Sports cardiologist has given me the green light to do resistance training on the understanding that I don't exceed 50% of my bodyweight on my upperbody, and allowed to do 100% bodyweight exercises on my legs/lower body - this isn't what I wanted to hear but it's a greenlight to "safely" do something moving forwards and stop muscle atrophy - all those years in the bank - muscle memory - fingers crossed high reps low weights ...

Sports cardiologist recommended I continue with current medication and trial beta blockers to stop/mitigate potential exercise induced vasodepression - declined beta blockers (speaking with other pharmacists/cardiologists not heard anything positive about beta blockers) - I then suggested to Sports cardiologist that I would take/trial them only on the days I do resistance training - not progressed this since as tbh I don't want to take more medication.

2.) Have gone back to the gym and have been working with Sports & Exercise Scientist/Exercise Referral Personal Trainer who is intrigued as to what has gone on..

Once a week for the last month or so I've been doing resistance training under his supervision to regain my confidence really that I am ok to do what I've been doing for the last 30 years but only once a week and at a lot light weight load.

In addition to this I have been doing a boxercise class aswell which has been fine.

3.) Good/"weird" news which doesn't make sense..

As suspected by the Sports cardiologist my blood pressure is indeed dropping, but not too low.

My Sports & Exercise Scientist/P.T has witnessed repeatedly my blood pressure before starting working out and after (measured with their BP and my BP monitor to confirm), and they are shocked, surprised and intrigued as to what is going on.... because for a normal personal BP should RISE after resistance training... mine is going the other way... wt....??!

My blood pressure is DROPPING to a perfect level after resistance training and Boxercise...
From my research, exercise vasodepression "might" be mitigated not as bad if a proper warm up & cool down is performed 5 mins before and 5 mins. I am also raising my knees 10 reps each side up to waist level - this helps return blood to circulation - wasn't aware of that.

4.) Medication issues - what to do next?

After 3 years of being on Amlodipine 10mg & Ramipril 5mg I have had to change dosage to 5mg Amlodipine & 10mg Ramipril due to swelling in my ankles - being someone who doesn't moan about things and used to tired legs from Soccer I hadn't noticed this until my wife and mother pointed it out to me.

Might change my medication/re-review.

5.) Tilt table & hereditary hypertension

Based on my own research & querying with Sports Cardiologist - a tilt table test is not required unless I have fainted, I have never fainted (touchwood) in my life. diagnosis of hereditary hypertension is due to my mother and father suffering from hypertension.

Moving forward I am thinking of changing my medications, maybe even reducing the dosages (is the BP medicine doing much??), doing more light resistance training (likely to drop my BP/bring it down based on proven BP data I am receiving), and trying to find another Sports Cardiologist for a 2nd opinion/backup who is more readily available (once/twice a year not enough) and will give me the time/attention I would like on a quarterly basis, for which I am more than happy to pay for on an ad-hoc basis.

I've already wasted alot of time to get this far ( 3 years) and thankfully I seem to have an excellent switched on Sports Scientist/P.T who is nudging me along in the right direction but with caution/parameters.

I am also now using a 24/7/365 wristband to track & monitor my BP, which is the only medically certified device available afaik with my Android phone.

Again as mentioned above, if anyone knows of a Sports Cardiologist who is a subject matter expert with Exercise induced Vasodepression please DM me/send me a link here.

Many thanks in advance

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