Managing Heart Conditions: Medication and Exercise Guidelines

Cardiac issues and medication concerns?

Dr.
Lin, I have been taking medication for hypertension for a long time, including 10 mg of Baken enteric-coated tablets, 5 mg of Anpress steady-release tablets, and 160 mg of Felodipine enteric-coated tablets.
Three years ago, I added 10 mg of Valsartan enteric-coated tablets.
In October of last year, I experienced chest pain, pain under my ribs, and chest tightness, so I visited the cardiology department at Chang Gung Memorial Hospital.
I underwent a stress electrocardiogram and an echocardiogram.
When reviewing the report, the doctor mentioned that I might have a myocardial infarction and recommended that I pay out of pocket for further testing.
I told him that it was a bit difficult for me to do so at the moment.
I took the report to my clinic, which also has a cardiologist.
After reviewing the report, he prescribed an additional medication, 60 mg of Tenormin extended-release tablets, to be taken with my hypertension medications, and 5 mg of Bisoprolol to be taken twice daily.
I also take a sleep aid, 0.5 mg of Lopinavir, every night before bed, along with 500 mg of calcium carbonate.

At the end of December last year, I was involved in a car accident and took three months off to recover.
Yesterday, after dinner, I went for a walk.
Initially, I was walking briskly and then ran two laps.
After running, I felt a sensation in my head as if blood was rushing to it.
I would like to ask if, given my medications, I should avoid intense exercise (the weather was a bit cold at the time).
Also, may I ask Dr.
Lin if I can switch to another doctor at the hospital? I have been seeing a clinic for hypertension since I was 28 years old, and my medication has been increasing.
For the past five years, I have been having blood tests every six months.

Cai Xiansheng, 30~39 year old female. Ask Date: 2016/03/27

Dr. Lin Jixiong reply Cardiology

Hello, the types and dosages of antihypertensive medications need to be adjusted over time.
As age increases and weight also rises, it may be necessary to increase the dosage and variety of blood pressure medications.
Dr.
Lin Chi-Hsiung.

Reply Date: 2016/03/27

More Info

Managing heart conditions, particularly when it involves medication and exercise, requires careful consideration and a tailored approach based on individual health status. In your case, it appears that you have a history of hypertension and have been prescribed multiple medications to manage your heart health. This includes antihypertensives like Betaloc (metoprolol), Amlodipine, and other medications for heart rhythm and potential ischemic symptoms.

Understanding Your Medications
1. Antihypertensives: Medications like Betaloc (metoprolol) and Amlodipine are commonly used to control blood pressure and reduce the workload on the heart. Metoprolol is a beta-blocker that can help manage heart rate and reduce symptoms of angina (chest pain), while Amlodipine is a calcium channel blocker that helps relax blood vessels.

2. Antianginal Medications: The addition of Tenormin (atenolol) and other antianginal medications suggests that your healthcare provider is addressing potential ischemic heart disease, which can manifest as chest pain or discomfort during physical exertion.

3. Sleep Aids: Medications for sleep, such as the one you mentioned (likely a benzodiazepine or similar), can have sedative effects that may influence your overall energy levels and response to exercise.

Exercise Guidelines for Heart Patients
Given your medical history and current medication regimen, here are some guidelines for managing exercise safely:
1. Consult Your Doctor: Before starting or modifying any exercise program, it’s crucial to consult with your healthcare provider. They can assess your current health status, review your medications, and determine if any adjustments are needed.

2. Start Slowly: If you have not been regularly active, begin with low-intensity activities. Walking is an excellent starting point. Gradually increase the duration and intensity of your walks as tolerated.

3. Monitor Symptoms: Pay attention to how your body responds during and after exercise. If you experience chest pain, significant shortness of breath, dizziness, or any unusual symptoms, stop exercising and consult your doctor.

4. Avoid High-Intensity Workouts: Given your history of chest pain and the medications you are taking, it may be wise to avoid high-intensity workouts or activities that could put excessive strain on your heart. Instead, focus on moderate-intensity aerobic activities, such as brisk walking, swimming, or cycling.

5. Warm-Up and Cool Down: Always include a warm-up and cool-down period in your exercise routine to help your body adjust to changes in activity levels.

6. Stay Hydrated and Dress Appropriately: Since you mentioned feeling flushed after exercise, ensure you are well-hydrated and dress appropriately for the weather to avoid overheating.

7. Regular Check-Ups: Continue to have regular follow-ups with your healthcare provider to monitor your heart health and adjust medications as necessary.

Conclusion
In summary, while exercise is beneficial for heart health, it must be approached cautiously, especially when managing conditions like hypertension and potential ischemic heart disease. Your current medication regimen indicates that your healthcare provider is actively managing your heart condition, and any changes to your exercise routine should be discussed with them. It is also advisable to seek a second opinion if you feel uncertain about your current treatment plan. Always prioritize safety and listen to your body as you engage in physical activity.

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