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Question
Posted by: Di L | 2007/12/13

HEART/LUNG FUNCTION

Hi, sorry heartdoc isn't available but i am sure you can help. I have a badly scarred left lung from having a tumour removed 39 years ago ( i am 47yrs old) and while undergoing a diving medical, it was discovered that I have an 'extra' beat in my heart, apparently from one side of the heart enlarging. This was caused by the heart battling to get O2 from the damaged lung and now one of the valves is leaking as well. My question is: if my heart is battling to get sufficient oxygen from that lung, am I doing it any favours by working hard in the gym? My average session starts off with a 10 min cycle (I cover about 4,2kms), then a toning circuit, a 1km walk ( also 10 mins) and then a 1km swim ( takes me about 25 mins). I have only ever experienced chest pain and nausea twice, but more recently I suddenly feel as if I hit a wall, start yawning and don't stop yawning for about 2 hrs. Doctors that I have asked usually say of course exercise is good for the heart, that is all well and good, but what about when the lungs are below par and the poor old heart is having to work that much harder. I failed the dive medical by the way!!

Thank you

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Our expert says:
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Hi Di

It's the leaky valve that I'd be more concerned about , to be honest. The extra beat, as for a skipped beat, is relatively common (though not always for the reasons yours has developed) and doesn't usually pose any major problems (although under the circumstances, I would not commit to that view point - a cardiologist is the better person to advise on that one).

Now, the leaky valve could develop into something if you're not careful. The problem here is that the normal pumping function of the heart could be impaired as a result of the valve not closing fully, and then blood is forced backwards, the wrong way. That is something you would need to be mindful of - perhaps your yawning is a symptom of this - it would fit.

now, as for exercise, i do believe that it is good, but under the circumstances, should be regulated very carefully. I don't think that the main problem you face is getting oxygen though - the body will tell you that pretty fast, it is designed to protect probably the brain from running out of oxygen and you'd develop symptoms that force you to stop exercise pretty quickly if it was a risk. However, that is the normal situation, and given yours, you would need to avoid this situation as much as possible, because a potentially weak heart would not respond well to too much stress from exercise.

It makes no sense, and may well be risky to exercise a 'damaged' heart because then the "stress" of exercise, which normally helps the heart get stronger, can become excessive and what one would call "uncompensable" - that is, your heart cannot adapt. So my earnest advice is that you need to consider seeing a specialist, face to face, and maybe have some tests on heart function done. That can check for cardiac function and tell pretty quickly if there is a problem with either blood pressure, electrical problems (the skipped beat/extra beat syndrome). So given your recent symptoms, I think it's important that we eliminate the guesswork and have it tested, and that means getting to your doctor, being referred to a cardiologist and then they will monitor you during controlled exercise and identify exactly what the prognosis is.

Good luck!
Ross

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