Weight lifting damages the heart, cardiologist said
Replies
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wonder how the hearts of the group that sat on their *kitten* thier whole life looked like
BOOM! I like it. I did 80% of my 1 RM and felt more like my *kitten* was going to fall of than I was going to have heart failure
OP- Hope you get well soon :flowerforyou:0 -
I got an email from Medhi (Stronglifts) that spoke to the pressure on the heart when you take a deep breath, hold it through the bottom of the move and then slowly release it on the way out.
He still recommends the practice as he argues that the heart builds endurance over time. I can see that this might cause problems in people with a condition.
I got a similar email, if I recall correctly, but I wonder if he bases this theory (that the "the heart builds endurance over time") on any data or if it's only his opinion. I surely did not find anything about that on any study I read.0 -
Bad analogy since prehistoric man generally didn't live long enough to die from heart disease. All they had to do for the species to survive is to live long enough to reproduce. That being said, I'm sure they didn't do enough of the strenuous lifting referenced in the articles to impact their CV health.0
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I got an email from Medhi (Stronglifts) that spoke to the pressure on the heart when you take a deep breath, hold it through the bottom of the move and then slowly release it on the way out.
He still recommends the practice as he argues that the heart builds endurance over time. I can see that this might cause problems in people with a condition.
I got a similar email, if I recall correctly, but I wonder if he bases this theory (that the "the heart builds endurance over time") on any data or if it's only his opinion. I surely did not find anything about that on any study I read.
Biology 101: the heart gets stronger as a result of increased exercise. Cardiac output increases (i.e. more blood is pumped with each beat) and the heart muscle itself gets stronger, same as any other muscle does when it's used more. This is why athletes tend to have lower resting heart rates than sedentary people. To what extent the cardiovascular system adapts to the blood pressure spike from lifting something heavy one time, but middle palaeolithic lifestyles seem to have involved a necessity to lift heavy things a lot, so I'd be surprised if the cardiovascular system is totally unable to adapt to lifting heavy things at all.0 -
Good information with a clear message - go see a professional to learn how to strength train appropriately and gain the maximum benefit for both muscular strength and cardiovascular health.
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Bad analogy since prehistoric man generally didn't live long enough to die from heart disease. All they had to do for the species to survive is to live long enough to reproduce. That being said, I'm sure they didn't do enough of the strenuous lifting referenced in the articles to impact their CV health.
except the issue is surviving the immediate consequences of the blood pressure spike from heavy lifting, i.e. not dropping dead as the result of heart failure from lifting something heavy, which would have resulted in the person not leaving any of their genes in the next generation.
also, prehistoric people did live into old age. There are skeletons of elderly people that are almost 2 million years old (Dmanisi, Georgia, if you want a reference to check this fact up).
ETA: the neanderthal anatomy has several features that would make them extremely good at deadlifting... why would they have evolved that way if picking heavy stuff off the ground wasn't vital for their survival?0 -
I must admit I would be rethinking my choice of cardiologist0
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Final year Biomedical scientist here - chose modules focusing on muscle and cardiovascular/respiratory system this year so hopefully I can put in some helpful input
The reason why weightlifting is contraindicated in people with, say heart failure, is because of the changes in blood pressure associated with that type of exercise:
First, an Equation:
Your mean arterial blood pressure = cardiac output (volume of blood pumped by the heart in one minute) x total peripheral resistance (determined by how much your blood vessels are constricted or dilated)
Ie MABP = CO x TPR
Dynamic (eg running) exercise raises CO as the muscle needs more oxygen. Blood pressure does not increase too much, as the blood vessels dilate (become wider) which lowers resistance to blood flow
Ie MABP (similar) = CO (increases) x TPR (decreases)
However, when you do isometric (static) exercise such as weightlifting, your muscles remain contracted throughout the exercise - the contracted muscle squeezes the blood vessels and prevents them from dilating much at all, so TPR does not go down.
So blood pressure increases dramatically.
In addition, when weightlifting, if you're straining, (a bit like when you go to the toilet), as if you're holding your breath but breathing out kinda, it has an additional effect on raising blood pressure (google Valsava manoeuvre if you want to learn more about how this works)
Conclusion:
So, isometric exercise like weightlifting raises blood pressure quite a lot. If you have a condition such as heart failure, damage to the heart, (or already have hypertension), where your heart is more 'fragile' so to speak, the increase in blood pressure can put you at risk of suffering a heart attack.
For normal, healthy individuals, the increase in blood pressure associated with weightlifting isn't too much of a concern. (Benefits outweigh risks).
Hope some of this info helps!
EDIT: forgot to mention (in case it's not clear) the increase in blood pressure isn't permanent, it's just whilst you're doing the exercise0 -
Conclusion:
So, isometric exercise like weightlifting raises blood pressure quite a lot. If you have a condition such as heart failure, damage to the heart, (or already have hypertension), where your heart is more 'fragile' so to speak, the increase in blood pressure can put you at risk of suffering a heart attack.
For normal, healthy individuals, the increase in blood pressure associated with weightlifting isn't too much of a concern. (Benefits outweigh risks).
EDIT: forgot to mention (in case it's not clear) the increase in blood pressure isn't permanent, it's just whilst you're doing the exercise
Thank you for posting this.0 -
I got an email from Medhi (Stronglifts) that spoke to the pressure on the heart when you take a deep breath, hold it through the bottom of the move and then slowly release it on the way out.
He still recommends the practice as he argues that the heart builds endurance over time. I can see that this might cause problems in people with a condition.
I got a similar email, if I recall correctly, but I wonder if he bases this theory (that the "the heart builds endurance over time") on any data or if it's only his opinion. I surely did not find anything about that on any study I read.
Biology 101: the heart gets stronger as a result of increased exercise. Cardiac output increases (i.e. more blood is pumped with each beat) and the heart muscle itself gets stronger, same as any other muscle does when it's used more. This is why athletes tend to have lower resting heart rates than sedentary people. To what extent the cardiovascular system adapts to the blood pressure spike from lifting something heavy one time, but middle palaeolithic lifestyles seem to have involved a necessity to lift heavy things a lot, so I'd be surprised if the cardiovascular system is totally unable to adapt to lifting heavy things at all.
I don't about Biology 101, but Exercise Physiology 101 demonstrates the nature of cardiac muscle hypertrophy is fundamentally different when it occurs from endurance cardio, heavy resistance training, or pathology. A thicker cardiac muscle is not necessarily "strong" or "healthy". And while cardiac muscle shares some characteristics of skeletal muscle and smooth muscle, it is not "the same as any other muscle" and it is incorrect to attribute the same training effects from lifting or running to cardiac muscle.0 -
Correct me if I'm wrong but this evidence suggests that resistance training spikes blood pressure.
Is there actually any evidence to suggest that it is implicated in causing damage to heart leading to clinical illness?
I found little data about this. Generally RT is considered safe by the AHA (but they advise against holding your breath while lifting and never recommend high intensity RT, as I wrote above).
From the statement: "Studies of cardiac morphology and function have consistently shown that the alterations associated with RT are physiological, although certain cardiac effects exist on a continuum between normal and pathological."
"Intensive RT characteristically increases left ventricular (LV) wall thickness and mass, with little or no change in LV diameter. Although statistically significant, the increase in wall thickness is modest, and values are generally in the upper range of untrained, normal subjects."
"In contrast to the increase in central arterial compliance associated with aerobic training, the effects of RT on this parameter have varied. Central arterial compliance was unaltered by whole-body RT in a prospective study of young healthy men. In contrast, an increase in arterial stiffness with RT has been demonstrated in the aorta and carotid arteries in association with an augmented central pulse pressure. In these studies, peripheral SBP was mildly increased but in the normal range, and DBP and mean BP were normal. Although it has been suggested that increased stiffness of large arteries may be an adaptation to obviate excessive expansion during severe isometric activity, the clinical implications of this finding are currently unclear. In summary, the influence of RT on both peripheral and central arterial compliance remains inconsistent and controversial at this time."
Fuether evidence that while Rippetoe may know a lot about compound lifts, he is pretty much a dumbass about everything else.0 -
I got an email from Medhi (Stronglifts) that spoke to the pressure on the heart when you take a deep breath, hold it through the bottom of the move and then slowly release it on the way out.
He still recommends the practice as he argues that the heart builds endurance over time. I can see that this might cause problems in people with a condition.
I got a similar email, if I recall correctly, but I wonder if he bases this theory (that the "the heart builds endurance over time") on any data or if it's only his opinion. I surely did not find anything about that on any study I read.
Biology 101: the heart gets stronger as a result of increased exercise. Cardiac output increases (i.e. more blood is pumped with each beat) and the heart muscle itself gets stronger, same as any other muscle does when it's used more. This is why athletes tend to have lower resting heart rates than sedentary people. To what extent the cardiovascular system adapts to the blood pressure spike from lifting something heavy one time, but middle palaeolithic lifestyles seem to have involved a necessity to lift heavy things a lot, so I'd be surprised if the cardiovascular system is totally unable to adapt to lifting heavy things at all.
I don't about Biology 101, but Exercise Physiology 101 demonstrates the nature of cardiac muscle hypertrophy is fundamentally different when it occurs from endurance cardio, heavy resistance training, or pathology. A thicker cardiac muscle is not necessarily "strong" or "healthy". And while cardiac muscle shares some characteristics of skeletal muscle and smooth muscle, it is not "the same as any other muscle" and it is incorrect to attribute the same training effects from lifting or running to cardiac muscle.
I was answering the question as to whether "the heart builds endurance over time" -not "how do different ways of exercising affect the way the heart gains muscle" - "same as any other muscle" in the context I was using it, means it gets stronger when used more just like how other muscles get stronger when used more. I didn't say it was exactly the same as other muscle tissue in every possible way that muscle tissue can be the same. It's a biology 101 answer - the heart gets stronger when you exercise - very general explanation about the general case.
I didn't even specify any kind of exercise until I got to the bit about saying I'm not sure how the cardiovascular system adapts to the demands of heavy lifting specifically... although re-reading it I phrased it badly... because that's what I meant to say (i.e. I'm not sure/don't know how it specifically adapts to this kind of exercise). The first part of the answer was about adaptation to exercise generally, the 2nd part was about lifting speficially, and I meant to say I don't know to what extent it adapts spefically to this kind of exercise, but I'd be suprised if it didn't because palaeolithic etc0 -
Since this thread is still meandering about, it's important to restate that the problem here is NOT that heavy lifting poses a cardiac risk to healthy individuals.
It's that 2 cardiologists who spoke to the OP hold opinions that are not only counter to the accepted tenets of exercise physiologists but are at odds with their own professional standard.
ANY exercise, especially vigorous exercise, imposes various physiologic loads on the body. By definition, during exercise there is always a transient increase is risk of an untoward acute medical event.
For most people, that transient risk is FAR, FAR outweighed by the fitness and health benefits of exercise. For young, healthy individuals, the "risk" from exercise itself is extremely low.
For someone with an underlying medical condition, however, the transient risk during exercise could pose an increased threat. In that case, the exercise might have to be modified or even contraindicated. But you can't compare that to a healthy person and use that comparison as an excuse to scoff at or ignore physiologic facts.0 -
weight lifting is not for everyone. not everyone is meant to be mr muscles or ms muscles. if it is not done properly, it can kill you. i know a person who passed out during training at high school and had to undergo brain surgery. i firmly believe that you have to work with someone knowledgeable from the start until you are an expert yourself if you want to do weight training. even if it is cardio, it has to be within limits. it's just harder to reach the danger limit in cardio it seems, because your body has time to warn you. in weightlifting, if you push too hard all of a sudden, yes, you are in a world of trouble. i see these PE teachers in college telling kids to "push yourself harder" while the kid is panting like he is about to drop and i shake my head. now that, is what you need to avoid.
your situation is quite touchy and if i were you, i would listen to the doctors. i agree with the doctor about how weightlifting is dangerous for anyone, given that most people are like those i mentioned above, they want more and more and fast. just like in martial arts, i think weight lifting needs to be monitored and tutored. you can't just go to some big name gym and have a guy tell you where the weights are and what you should do(i find that big name gyms try to make you quit actually by pushing you into boring and impossible workouts at the beginning). just like everything in life, if an expert shows you the way to become an expert yourself, you take certain risks, that's for sure.0 -
I had cardiac ablation for Supraventricular Tachycardia and my doctor never ever said anything like that! I would think that unless you have high blood pressure there would be no issues with ST.
Give the surgery a month before you can tell if it worked. My heart fluttered about like mad for a month and I thought he made it worse! I went on to lose 30 pounds after my surgery and I'm still here!
I'm glad to hear that, and congratulations for your achievement! For the first three weeks I felt much worse than before the surgery, while this week I'm actually starting to feel better: I take it as a good sign :-)
But did you specifically asked your doctor about strenght training? Because my cardiologist told me that I could resume my physical activities a few weeks after the operation without worries, it's only when I asked about strenght training that I got a (very) negative answer.0 -
Since this thread is still meandering about, it's important to restate that the problem here is NOT that heavy lifting poses a cardiac risk to healthy individuals.
It's that 2 cardiologists who spoke to the OP hold opinions that are not only counter to the accepted tenets of exercise physiologists but are at odds with their own professional standard.
ANY exercise, especially vigorous exercise, imposes various physiologic loads on the body. By definition, during exercise there is always a transient increase is risk of an untoward acute medical event.
For most people, that transient risk is FAR, FAR outweighed by the fitness and health benefits of exercise. For young, healthy individuals, the "risk" from exercise itself is extremely low.
Agreed. The general consensus is that resistance exercise is relatively safe for young and healthy individuals. Just avoid the Valsalva maneuver.
Reading the AHA statement though it seems that there are still some gray areas - mainly because "most studies of RT have enrolled selected, low-risk individuals, and many are too small to provide reliable estimates of event rates on a population-wide basis". Not everyone is young and perfectly healthy, and I'm not talking about serious issues or cronic heart diseases: high blood pressure is a really widespread condition, diabetes too, retinopathies are not uncommon in people of a certain age, and so on.0 -
Interesting read. I look at this issue like this: Many of us exercise in order to try and stay fit and healthy for life. Hopefully a long and active life, (but none of us are guaranteed anything, but we can increase our odds). Strength is an important part of that equation. But, like most things, overall moderation may be the key. In studies of the places where people live the longest, natural exercise is part of their lifestyle. Like Sardinian sheep herders for instance - walking all day around steep, rocky terrain and having to pick up and help sheep out of situations. But, must of their time is spent in very moderate exercise - hiking around.
Contrast the way that many of us lift. We arrive at the gym from sitting at a desk all day. Within a few minutes, we are laying on a bench and straining hard, holding our breath as we lift. Many years of this is probably not good. Kind of like jumping in a car on cold mornings and revving the engine at high rpm. As we age, many things can erode in our cardiovascular system - arteries, heart walls, valves etc. This unnatural increased pressure will eventually take it's toll.
We should probably add much more time to the warm up phase of our exercise and increase gradually. We should probably practice good breathing through all exercises (look at some of the yoga logic on this) and not do the breath holding maneuver (I'm bad about this). And also, for a long and healthy life, mostly moderate weight lifting vs. high intensity, heavy lifting as a regular practice.
For those like the OP, that have an identified health issue, it might be best not to regularly lift weights. Or to use a highly modified and more aerobic (lower weights, good breathing) weight routine. All the best to you OP.0 -
in for a read later !0
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Since this thread is still meandering about, it's important to restate that the problem here is NOT that heavy lifting poses a cardiac risk to healthy individuals.
It's that 2 cardiologists who spoke to the OP hold opinions that are not only counter to the accepted tenets of exercise physiologists but are at odds with their own professional standard.
ANY exercise, especially vigorous exercise, imposes various physiologic loads on the body. By definition, during exercise there is always a transient increase is risk of an untoward acute medical event.
For most people, that transient risk is FAR, FAR outweighed by the fitness and health benefits of exercise. For young, healthy individuals, the "risk" from exercise itself is extremely low.
Agreed. The general consensus is that resistance exercise is relatively safe for young and healthy individuals. Just avoid the Valsalva maneuver.
Reading the AHA statement though it seems that there are still some gray areas - mainly because "most studies of RT have enrolled selected, low-risk individuals, and many are too small to provide reliable estimates of event rates on a population-wide basis". Not everyone is young and perfectly healthy, and I'm not talking about serious issues or cronic heart diseases: high blood pressure is a really widespread condition, diabetes too, retinopathies are not uncommon in people of a certain age, and so on.
I can't speak to all the details of the AHA statement since I didn't memorize it, but there is no question that overall health status always needs to be taken into consideration. My biggest problem with the one cardiologist was his saying that heavy lifting was bad for everyone regardless of age or condition.
"Heavy" can also be somewhat relative. Compared to some one who is not only doing nothing but 15-rep sets and not even working to fatigue, just going to 10 reps and fatigue will result in dramatic improvements -- and many adults never have to go any heavier than that. And that level is safe for a large majority of adults over 50.0 -
If weight lifting were really important to my all around personal well being I would consult a reputable specialist in Sports Medicine.0
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Interesting read! ( I hold my breathe while lifting, it's a terrible habit!!)0
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From the CDC, which encourages senior citizens to work out with weights:
http://www.cdc.gov/physicalactivity/growingstronger/index.html?s_cid=tw_ob2760 -
From the CDC, which encourages senior citizens to work out with weights:
http://www.cdc.gov/physicalactivity/growingstronger/index.html?s_cid=tw_ob276
Recommended set and rep range - 2 x 10, and their description of what constitutes a good workout is going to fall below the 80% 1RM.
Ask yourself these questions after each exercise.
Were you able to complete two sets of ten repetitions in good form?
No: Reduce the weight to an amount that you can lift ten times in good form; rest for one or two minutes, then repeat for a second set.
Yes: Please continue to question two.
After completing ten repetitions, do you need to rest because the weight is too heavy to complete more repetitions in good form?
Yes: You are working at the proper intensity and should not increase weight.
No: Please continue to questions three and four to determine how to safely increase the intensity of your workout.
Could you have done a few more repetitions in good form without a break?
Yes: If you can do only a few more repetitions (not the entire next set of ten without a break), then at your next workout you should do the first set of repetitions with your current weight and your second set with the next weight up. For example, if you're currently using one-pound dumbbells, use two- or three-pound dumbbells for your second set.
Could you have done all twenty repetitions at one time, without a break?
Yes: At your next session, use heavier dumbbells for both sets of repetitions.
And several recommendations about breathing out on contraction.
So their advice fits in with the advice found by OP. Which is surprising, I didn't think this government agencies talked to one another.0 -
ok0
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Since this thread is still meandering about, it's important to restate that the problem here is NOT that heavy lifting poses a cardiac risk to healthy individuals.
It's that 2 cardiologists who spoke to the OP hold opinions that are not only counter to the accepted tenets of exercise physiologists but are at odds with their own professional standard.
ANY exercise, especially vigorous exercise, imposes various physiologic loads on the body. By definition, during exercise there is always a transient increase is risk of an untoward acute medical event.
For most people, that transient risk is FAR, FAR outweighed by the fitness and health benefits of exercise. For young, healthy individuals, the "risk" from exercise itself is extremely low.
Agreed. The general consensus is that resistance exercise is relatively safe for young and healthy individuals. Just avoid the Valsalva maneuver.
Reading the AHA statement though it seems that there are still some gray areas - mainly because "most studies of RT have enrolled selected, low-risk individuals, and many are too small to provide reliable estimates of event rates on a population-wide basis". Not everyone is young and perfectly healthy, and I'm not talking about serious issues or cronic heart diseases: high blood pressure is a really widespread condition, diabetes too, retinopathies are not uncommon in people of a certain age, and so on.
Sorry about your surgery, the hassle of recovery and the all the pain and worry all of that causes.
Thanks for an interesting thread - I think that here is a place were generalizations are likely to be of limited value. So it makes sense to dive into some of the details of cardio pathology.
First off - it's correct to asume that Resistance Training and volume loading of the heart are generally good for the individual without heart disease. Most cardiologist only see sick hearts - so it might be a factor in your doctors' opinion that weight training is dangerous for anyone. I would not take that on with too much belief. For you? I'd suggest you discuss with another doctor what type of exercise you may or may not carry out.
From the point of view of cardio physiology work (valve design and material testing, 20 years ago) - the Valsalva Maneuver will increase some risks while not affect others at all It's used as a detection tool where value issues such as forward leakage or hypertrophy exists - where there is a valve narrowing or valves that close incompletely, the maneuver actually reduces the disfunction.
The Valsalva Maneuver can be quite useful in allowing someone to reach a better PR, or to protect your back during a heavy lift, etc. but it does have some risks. Personally, I've stopped using it after having burst blood vessels in my eyes (most likely related, maybe due to my improper use but also reported in the literature).
For someone like me, beginner/intermediate lifter not going for a 1RM max there really is no need for the maneuver. Inhale/easy and exhale/hard part. If you practice it, it should be a short sec part of a lift to avoid oygen reduction and reduce pressure gradients.0 -
So their advice fits in with the advice found by OP. Which is surprising, I didn't think this government agencies talked to one another.
:-)
There is a table in the latest AHA statement summarizing the guidelines and statements regarding resistance training, and the recommended set/reps are quite consistent between studies:
Resistance Training
Healthy/sedentary adults
2007 AHA Scientific Statement
1 set; 8-12 reps for persons < 50-60 y of age; 10-15 reps at reduced levels of resistance for persons 50-60 y of age
8-10 exercises
2006 ACSM Guidelines
1 set; 8-12 reps (range, 3-20 reps) performed at a moderate rep duration (3 s concentric, 3 s eccentric)
8-10 exercises
Elderly persons
2001 American Geriatrics Society
Low: 40% 1-RM; 10-15 reps
Moderate: 40%-60% 1-RM; 8-10 reps
High: >60% 1-RM; 6-8 reps
Cardiac patients
2007 AHA Scientific Statement
1 set; 10-15 reps 8-10 exercises
2004 AACVPR American Association of Cardiovascular and Pulmonary Rehabilitation guidelines
1 set; 12-15 reps 6-8 exercises
2006 ACSM guidelines
1 set; 10-15 reps 8-10 exercises0 -
Sorry about your surgery, the hassle of recovery and the all the pain and worry all of that causes.
Thanks for an interesting thread - I think that here is a place were generalizations are likely to be of limited value. So it makes sense to dive into some of the details of cardio pathology.
First off - it's correct to asume that Resistance Training and volume loading of the heart are generally good for the individual without heart disease. Most cardiologist only see sick hearts - so it might be a factor in your doctors' opinion that weight training is dangerous for anyone. I would not take that on with too much belief. For you? I'd suggest you discuss with another doctor what type of exercise you may or may not carry out.
Thank you for the info and I agree with you, of course. I will definitely find another cardiologist once the recovery phase will be over. According to all the tests my heart is healthy so if the surgery succeeded and the fibrillation subsides I don't see too much risk in performing a moderate to intense RT routine. Probably I will have to switch from 5x5 to a safer 8-12 repetition range, but that I can gladly accept.0 -
I have Afib & Aflutter and had flutter ablation two years ago, which DID help. Please note my doctor thought I couldn't tell the difference between the two, and thinks my flutter might be fast Afib, but the flutter had been caught once while I was at the doctor's (thank goodness) so he was willing to do flutter ablation, which is less invasive and more effective. He was pleasantly surprised that it helped - a lot!
I was able to take my propaphenone back down to the lowest dosage.
Now the arrhythmia is coming back and he's sure it's fast Afib (again) but I'm still in a range to control it by increasing propaphenone. He says the propaphenone may lose its efficacy (is that the right word for "not work as well"?), so I'm a little alarmed.
Anyway, I lift light - dumbbells - and am 62 years old, so, we're different. But my point is, sometimes I've been in Afib, and working out lightly seems to help it go away. Other times, I've felt it right on the edge, and I immediately shut down all strains (especially worry & concentration) and have been able to calm it down before it goes into a full-fledged episode. I'm not sure if mental stress is different/worse than physical stress. I think pushing both "too hard" affect it.
BTW, I have a little Pulse Oximeter that has a screen that shows the heart rhythm, so it isn't all in my head. I can see the arrhythmia pattern happening. And I can feel it too. Because I've seen the pattern when the doctors say "Oh that was Afib" or "Oh that was flutter" I can equate the feeling with the pattern. Not a guarantee I've got it down pat, but an indicator.
Best wishes!
Paula0 -
Thank you for all the info in this thread. Being one of the folks where RT is contraindicated (severe pulmonary hypertension and congestive heart failure) I was angry about not being able to lift as I have read so much about the benefits. Finally we have gotten my pulmonary hypertension under control to a point where I can start very moderate RT! I will probably never "lift heavy" as they say, but this is a start, and with supervision (I get in trouble unsupervised) maybe I will get close!0
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Get well soon OP.
Its well noted that blood pressure is increased while lifting heavy but I'm more inclined to believe that'd be good for your heart. Whether it's good for YOUR heart is a different story - I wouldn't take that diagnosis lying down though, I don't know about you but being told I'd never be able to do it again would devastate me. I'd research some more and get a third (and forth and fifth etc., if it was me) opinion before resigning yourself to never doing it again.
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