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arrythmia - palpitations


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rebelatheart
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PostPosted: Fri Apr 20, 2018 10:29 am    Post subject: Another related question Reply with quote

I stumbled across this old post and read with great interest, having gone through 9 years of paroxysmal atrial fibrillation before I finally had it taken care of with ablation. The other issue I face now is that the CT scan they performed before my ablation procedure revealed a 4.2cm thoracic ascending aortic aneurysm. As someone who has played trumpet all my life and also excercises almost exclusively by weight training, you can see that I have quite a problem. I am guessing that I can reduce to a degree the increase in intrathoracic pressure while weight training if I breath properly and train with lighter weights and higher reps,being careful not to perform the valsalva maneuver the best I can, but what about playing the trumpet? Is that something to now avoid? We as talking major change in lifestyle for me here.
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TrumpetMD
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PostPosted: Fri Apr 20, 2018 3:39 pm    Post subject: Re: Another related question Reply with quote

rebelatheart wrote:
I stumbled across this old post and read with great interest, having gone through 9 years of paroxysmal atrial fibrillation before I finally had it taken care of with ablation. The other issue I face now is that the CT scan they performed before my ablation procedure revealed a 4.2cm thoracic ascending aortic aneurysm. As someone who has played trumpet all my life and also excercises almost exclusively by weight training, you can see that I have quite a problem. I am guessing that I can reduce to a degree the increase in intrathoracic pressure while weight training if I breath properly and train with lighter weights and higher reps,being careful not to perform the valsalva maneuver the best I can, but what about playing the trumpet? Is that something to now avoid? We as talking major change in lifestyle for me here.

I remember this thread, which was based on several unsubstantiated statements by the OP.

Sorry to hear about your aneurysm. As you know, an aortic aneurysm is an important issue. For some patients, a physician may impose limitations on exercise or other activities. This is a discussion you need to have with him/her.

Regarding your questions about what to avoid, let me suggest the following. Playing the trumpet is similar to moderate metabolic activity (jogging, sexual activity, bike riding), and is also similar to moderate weight training with free weights. These aren't hard-and-fast comparisons, and there are exceptions. But they might help you to communicate with your physician about the demands of trumpet playing, so you can talk to him/her about any adjustments/limitations that might be needed.

Mike
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bear30101
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PostPosted: Fri Apr 20, 2018 3:41 pm    Post subject: Reply with quote

If you search Cleveland Clinic Cardiac Web Chat Transcriptions, you will find a chat (8/21/17) involving Aortic Aneurysms. I asked for, and received an opinion about the effect of trumpet playing on aortic aneurysms.
I would discuss YOUR case with cardiologists and get several opinions.
I also suggest you investigate Jim Manley's approach to playing.
Good luck.
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ohiotpt
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PostPosted: Fri Apr 20, 2018 3:50 pm    Post subject: Reply with quote

For what it's worth ran your post by:

Cardiologist (MD) - Interesting question, hey, if he's smoking tell him that's the bigger worry (looking at your avatar). Not sure about trumpet playing. Is he a professional? Would hate to take away his lively hood. Weight lifting is a concern because blood pressure can shoot up. Why not run it by the thoracic surgeons.

Physician Assistant for the thoracic surgeons - 4.3, that's not that bad. Does he smoke? That would be huge a concern. Don't think trumpet playing would be a problem. Make sure he's followed regularly.
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Andy Del
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PostPosted: Sat Apr 21, 2018 1:42 am    Post subject: Reply with quote

Well... back in my unfit youth, I used to get palpitations all the time playing. Once I decided to get fit, they ceased.

Fast forward to the present. Last year I was diagnosed with Brugada Syndrome. This is a inherited genetic condition that is a channelopathy: essentially, my heart can stall. The only treatment is to have a defibrillator implanted which I got before I was allowed home post arrest.

I had my regular clinic for monitoring the defib last week, and there were 4 recorded events. 1 of about 3 seconds of Ventricular Fibrillation - which appears to have spontaneously stopped.

The other 3 events were very close together and on examination, I was able to tell them exactly what I was doing - playing the Vivaldi double concerto! As we looked into it, the ECG showed it was simply a fast heart rate, about 150 bpm.

I also have periods of dizziness when playing at times. Talking to my cardiologist he feels this is due to thoracic pressure decreasing the flow of blood into the heart. Slightly more worrying are rather sharp pains in my left arm pit which can radiate down my arm and side when exerting myself (borth playing and in other, ahem, situations). And there is no overt structural issues, DVT, thoracic blockage syndrome, etc...

This getting old is a PITA! Bottom line, look after yourself and get the VERY best cardiologist you can!

cheers

Andy
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malden
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PostPosted: Tue Apr 24, 2018 4:31 am    Post subject: Reply with quote

Quote:
but what about playing the trumpet? Is that something to now avoid? We as talking major change in lifestyle for me here.


I am a TAA patient as well....46mm. I have posed the question about trumpet playing to one of the leading TAA experts from Yale Medical Center. I will post his answer when and if I get one. And I am scheduled at NYU Langone Center soon and will ask the TAA specialists there as well

It never occurred to me that trumpet playing or singing (do both) would be a risk factor. But sometimes playing the trumpet feels like heavy lifting and my pulse does go up. So it is wise to check this out.

Cheers
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chuck in ny
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PostPosted: Mon Apr 30, 2018 1:36 pm    Post subject: Reply with quote

the subject scares the crap out of me. you have to be up to the task with your heart and lungs to be able to play.
i think the average person can distinguish between a shot lived event where the heart beats a little differently, and something that is putting unhealthy strain on the heart and tearing things down.
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cgaiii
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PostPosted: Fri Jun 15, 2018 8:12 pm    Post subject: Reply with quote

Interesting topic. I am glad to see some MDs commenting. My family has a history of Atrial Fibrillation. Both parents, all my siblings including me. I have an excellent cardiologist who does research on afib. From my family I know that the affects are very different on different people, from my sister who never knew she had a problem to me, where afib episodes would take my breath away. About 10 years ago I had my first symptoms -- sudden and violent accompanied by wild tachycardia and requiring cardioversions. My cardiologist tried a series of drugs including Multac, but I did not get along with them at all (lots of side effects) and in the end we opted for a pulmonary vein isolation (ablation). It worked well for about 8 years, then symptoms returned, though much milder than before, gradually getting more and more frequent, all converting back in a reasonable time but beginning to interfere with my life. So we opted for another ablation (same type). My cardiologist said only a few reconstructed paths afterwards. This was done a week ago.
I specifically asked her about trumpet playing after the procedure, how soon I could start. She at first said it should be no problem, but when I explained that there is some pressure build up in the abdomen and body. She said to lay off for awhile, similar to the layoff for heavy lifting over 10 lbs. Still in the layoff now, but I feel pretty strong now. Have a follow-up on Tuesday and will ask specifically again. No matter when I return I will start in the low register with the least pressure and go slow. It just makes sense.
Additionally, I tried to pin my episodes on events, like playing. My conclusion is that they were totally random unless I had some stimulant such as caffeine, chocolate or something like that in enough of a "dose." Then I could pretty much be assured an episode would happen. Needless to say, I cut these substances out entirely when my symptoms returned.
I would be curious about what the doctors here feel about energy drinks, such as 5 hour energy. Obviously they are full of caffeine and I would avoid them just for that reason, but I wonder if they could actually be contributory to a person with a genetic propensity toward afib developing it.
Sorry for such a long post.
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blbaumgarn
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PostPosted: Mon Jun 18, 2018 9:44 pm    Post subject: arrythmia-palpatations Reply with quote

Three weeks ago monday I had my first heart event. Went into emergency room and four hours later had a stent. Am doing the prescribed meds, change in diet, which was very welcome, and everything else prescribed. I was told I could start practicing again within a week. At 68 I don't play long anymore and I am not in the mode as through my 20s and 30s of trying to play all the Maynard or Bill Chase riffs, but I can still practice and without arrythmia. That is something different they tell me. I have regular palpatations every time I see Jessica Biel or Scarlett Johansson on tv, but that isn't going away, I don't think. Regards to everyone.
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Don Herman rev2
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PostPosted: Tue Jun 19, 2018 10:04 am    Post subject: Reply with quote

And hopefully your last! Glad you're doing well.
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