Dear Sports Doc, Show
I am 57 years old and I was a runner from 11 years old to my mid-forties. When I was in my prime in high school and college my heart rate averaged 48 - 50 bpm. I was a decent runner with a 4:30 mile and 9:40 2-mile in high school and 24:55 5-mile in college cross-country. I had to stop running because I started suffering from osteoarthritis of the hip, which needed to be replaced. About a year ago, I went to my local VA clinic to have an EKG to get cleared for my hip operation. According to the EKG my heart rate was in the low 30s, which was not normal for me. They rushed me to the local hospital and installed a pacemaker in my chest. This was very difficult for me to absorb; I thought I was invincible and would live forever. Approximately six months after the pacemaker was installed, I had my hip replaced. I have been riding a bike to try and get myself into some kind of shape, but I have problems climbing stairs or bending over. It doesn't happen all the time, but I have heavy breathing episodes. The tech's from Boston Scientific state that I have Atrial Fibrillation (A Fib). I take 100 mg metoprolol tartrate twice a day along with one full aspirin in the morning; I also take a 40 mg tab of simvastatin before going to bed. When I went to the VA clinic that day for the EKG I was not symptomatic, I had no problems breathing until I had the pacemaker installed. Today I forgot to take my medicine in the morning and I felt much stronger on my bike than I have on previous rides. Do you think the beta blocker I am taking could be causing my breathing problems and if so, what would be an alternative solution? Any advice you can provide would be appreciative. More From Runner's World Thanks, Donald Dear Donald, There are several points to discuss regarding your story and thank you for sharing. It is difficult to have a change in life circumstances and you have been hit hard with a pacemaker and a total hip replacement. Aging can be brutal and it certainly takes away that feeling of invincibility. First, if you are short of breath with activities, you must see your physician soon. I cannot give you any meaningful advice, but may be able to help with some explanations. As you noted, long time endurance athletes have low resting heart rates. When I am at peak training for in-line skate marathons or doing a lot of Nordic skiing, my morning heart rate is in the low 40s, with my regular fitness activities it is just below 50, and when I was out of action recovering from my total hip and total knee surgeries my heart rate drifted up toward 60. Somewhere below 40 and for sure at 30 beats per minute, the natural pacer has gone on strike and the cardiac output is too low for safety. A pacemaker is the usual intervention. Thankfully we live in an era with good pacemakers and long-life batteries. Beta-blockers are another story. They slow your heart, cause fatigue (especially with exercise), and are often used to control atrial fibrillation. Beta blockers are also used for congestive heart failure, high blood pressure, and after heart attacks. You may be able to use a lower dose of the metoprolol or there may be alternate medications that your physician can discuss with you. Be sure to tell him or her about your symptoms. It would be best to get your breathing problem evaluated so you can get back to your fitness plan. I do not recommend running on a new hip at age 57, although many people do. Personally, I have moved to biking and other low impact activities. I think about keeping my new hardware as close to intact as possible to avoid getting another replacement in 20-30 years. I hope this helps. Cheers, Bill *** Have a question for the Sports Doc? Email him at . NOTE: Due to the volume of mail, we regret that Dr. Roberts cannot answer every email. This content is imported from OpenWeb. You may be able to find the same content in another format, or you may be able to find more information, at their web site. Beta blockers work mainly by slowing down the heart. They do this by blocking the action of hormones like adrenaline. Beta blockers usually come as tablets. They are prescription-only medicines, which means they can only be prescribed by a GP or another suitably qualified healthcare professional. Commonly used beta blockers include: Beta blockers may be used to treat: Less commonly, beta blockers are used to prevent migraine or treat:
There are several types of beta blocker, and each one has its own characteristics. The type prescribed for you will depend on your health condition. Who can take beta blockersBeta blockers are not suitable for everyone. To make sure they are safe for you, tell your doctor before starting a beta blocker if you have:
Tell your doctor if you're trying to get pregnant, are already pregnant or breastfeeding. It's important not to stop taking beta blockers without seeking your doctor's advice. In some cases suddenly stopping the medicine may make your health condition worse. Cautions with other medicinesThere are some medicines that may interfere with the way that beta blockers, including beta blocker eyedrops, work. Tell your doctor if you're taking:
Side effects of beta blockersMost people taking beta blockers have either no or very mild side effects that become less troublesome with time. Contact your GP if you're having symptoms that bother you or last more than a few days. Side effects commonly reported by people taking beta blockers include:
It happens rarely, but some people have serious side effects when taking beta blockers. Tell a doctor straight away if you have:
These are not all the side effects of beta blockers. For a full list, see the leaflet inside your medicine packet. You can report suspected side effects using the Yellow Card Scheme. For more information on the side effects of beta blockers, read about the specific medicine you take in our Medicines A to Z. Missed or extra dosesMost beta blockers are taken once a day, apart from certain beta blockers that are used during pregnancy and Sotalol, which is given 2 or 3 times a day. What if I forget to take it?If you forget to take a dose of your beta blocker, take it as soon as you remember, unless it is nearly time for your next dose. In this case, just leave out the missed dose and take your next dose as normal. Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one. If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine. What if I take too much?An overdose of beta blockers can slow down your heart rate and make it difficult to breathe. It can also cause dizziness and trembling. The amount of beta blocker that can lead to an overdose varies from person to person. Call your doctor or go to A&E straight away if you take too much of your beta blocker. Page last reviewed: 16 July 2019 Do beta blockers make it harder to exercise?Beta blockers slow the heart rate, which can prevent the increase in heart rate that typically occurs with exercise. This means that it might not be possible for you to reach your target heart rate — the number of heartbeats per minute you typically aim for to ensure you're exercising hard enough.
Can beta blockers make you feel out of breath?It happens rarely, but some people have serious side effects when taking beta blockers. Tell a doctor straight away if you have: shortness of breath with a cough that gets worse when you exercise (like walking up stairs), swollen ankles or legs, chest pain, or an irregular heartbeat – these are signs of heart problems.
Why do beta blockers make you short of breath?Other less common side effects include: Difficulty breathing. Beta-blockers can cause lung muscle spasms that make it difficult to breathe. This is more common in people who have lung conditions.
How do you exercise when taking beta blockers?Since beta blockers slow the heart rate to deceptively low levels, it's important to avoid overexertion while exercising. Before starting a new workout program, talk to your healthcare provider first. Your physician can tell you what your target heart rate should be and create a custom exercise plan.
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Why do beta blockers cause shortness of breath when exercising
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