Heart rate questions?

[frescrim7]

Hello good morning. For 7 months I have been experiencing symptoms of muscle weakness and fatigue on the left side of my body. It is not yet clinical weakness. but the deltoid and quadriceps and tibialis anterior of my left leg get fatigued as soon as I put some weight on. I also have a high heart rate to the minimum that I make any physical effort. see a neuromuscular neurologist and he told me he doesn't detect any signs of MMD. I have 4 EMGs since then all clean. my question is. Is elevated heart rate on exertion related to ALS? After 6 months of symptoms and the last clean Emg performed on October 4. can MND be ruled out so soon? My neurologist did not examine my deltoid in the emg but he did examine the biceps and the first dorsal interosseous, would that be enough? thank you very much for everything. You are angels.

 

[lgelb]

No. You should see a primary care doc to rule out cardiovascular and pulmonary issues, and to get a referral to address your anxiety, for you have been here way too often for your mental health.
Yes. 6 months w/ sx/no clinical weakness/4 EMGs is plenty for a ruleout.
Yes. It is customary to look at both muscles with perceived issues and those without.

Best,
Laurie

 

[affected]

I agree with the response you already have and would say:
1. no heart rate is not related
2. clinical weakness is the first sign you should experience, not the one you are waiting for
3. can MND be ruled out so soon? are you kidding? this isn't 'so soon' you have 4 EMG in that time frame, and the doctors really do a lot of training and know which muscles to test, regardless of what you think would be right.
you need to stop, go back to your GP and ask for help with the heart issues if they are truly an issue.
I truly wish you the best in working this out, but this is not going to be ALS

 

[lgelb]

You posted regarding having had Epstein-Barr (in Spanish, therefore deleted) -- yes, the effects can be prolonged and I would definitely return to your PCP for monitoring, even though there may not be too much they can do. You may need to more gradually come back up to your previous level of physical fitness.

 

[frescrim7]

thank you very much for answering. I am a nurse and I work in neurology, perhaps seeing so many patients with als I can be a little anxious. But the high heart rate if it has to do indirectly with als due to a less capacity of the diaphragm is a cardiac compensation mechanism against the drop in oxygen in the blood. what puzzles me in my case are the clean emgs. It is clear that there can be no als for that. and pls i also have the reflections studio ok. In short, an epstein barr that could cause everything could be. my imaging tests are negative so I am puzzled by this left-sided focused weakness, exercise intolerance, dyspnea, and tachycardia.

 

[affected]

You are confusing yourself with someone with advanced ALS to start with.
Then you are also confusing what happens to a PALS with compromised breathing, to what you know about any other respiratory issue.
PALS don't usually have any great drop in O2, they have a rise in CO2.

Please, take your concerns to your doctor, this is not ALS.

 

[lgelb]

Right, it is clear that you don't have ALS. So it seems time to explore what you might have, to explain the features you mention, with an internist. It could be E-B or a complication or something else entirely.

 

[frescrim7]

I've had a month with difficulties to vocalize and with a low tone of voice. the people who accommodate me don't realize it. My tongue got tired when I spoke, also my vocal cords, I imagine that none of this will continue to sound als. I went to see the endocrinologist and he sent me a battery of tests that all went well. so i'm baffled. I'm going to run and my heart rate goes to a thousand. I have chest rx well too. is that I do not know everything leads me to something neuromuscular but those clean emg after 6 months of symptoms ... they baffle me. I am finding great support on this forum to fight my frustration.

 

[Nikki J]

I do not believe a heart rate of a thousand is physiologically possible in a human How do you determine it ? But if you have severe tachycardia you should be under the care of a cardiologist. The most common reason for clean emgs is that something else is causing your symptoms

 

[frescrim7]

Sorry, with a thousand keystrokes I meant that I get very something just start running maybe 160 in 4 minutes. in my left arm I can barely take more than 5 kilos without fatigue and give up. but of course here the gold standard is that a clean emg is that there is no ela and I accept it but emgs at the beginning maybe in 6 months they can give negative. ie an emg in a muscle where I feel perceived weakness and nothing appears does it mean there is no als? I have given a monthly contribution to the forum, I want to help with whatever it takes. sorry for tofersen results. in my hospital we were aware. a greeting

 

[lgelb]

You ask if a clean EMG in a muscle you are perceiving problems in means no ALS...the answer is yes.

You talk about a "gold standard here" that is the gold standard everywhere -- a clean EMG and clean exam excludes neuromuscular disorders entirely.

I think we have completed the circle -- we don't know what you have beyond E-B if anything, but it's not ALS. Meanwhile, you could be overtaxing your heart or lungs for another reason entirely if you do not receive a cardiopulmonary evaluation. Even anxiety can call for a medication that reduces your heart rate/the force of its contractions and there can be true damage if the heart and blood vessels are taxed beyond their normal capacity over time. So please look at the risk in front of you, not the one that is only in your mind.

Closing this thread to help you focus on that. Please do not start another.