I receive lots of questions from athletes every week. They seem to come in topical groups. For some unknown reason this spring I’ve gotten a lot of questions from athletes who believe their heart rates are abnormally high during exercise and imply that they are concerned that they may have a cardiovascular problem. One guy even recently wondered why his heart didn’t explode. I don’t know if he was kidding but it’s the sort of thing many seem to be wondering this spring. So rather than continuing to reply to this same question repeatedly I thought I’d simply answer it here and then refer people to it when they query me. I also asked Dr. John Post, an old friend of mine and the Medical Director for TrainingBible Coaching, to comment from a medical perspective. He and I separately wrote a general reply. They seem to overlap quite a bit. So, here we go…
The first matter is to understand what “high” heart rate means. High relative to what? If it’s high referenced against the formula 220 minus your age then realize that this is seldom correct for anyone. If we found the max heart rates of a large group of people and graphed them we’d more than likely get a bell-shaped curve. There would be a lot of people in the middle for whom the formula was close, there would be some to the left end for whom the formula was too high (low normal heart rates), and to the right end of the curve would be those for whom the formula was too low (high normal heart rates). For people on the right end of the curve, chronically “high” heart rates while exercising are normal. They don’t have a problem, at least not based strictly on their heart rates.
Or if “high” heart rate means it’s high relative to your training partners' then this is essentially the same matter as the 220-minus-age formula. If this defines “high” then, in the absence of any other symptoms (such as light headed; nauseous; pressure, pain or discomfort in chest, arm, neck or jaw), you are probably good to go. You don’t have a problem. You just are on the right end of the bell-shaped curve.
These normal high or low heart rates also have no bearing on performance. I once coached a US National Age Group Time Trial Champion who broke the record for his age group. His 20k time trial heart rate was around 145. This didn’t slow him down. I also once coached a runner with a max heart rate in the high 210s. I’ve also coached athletes with big feet and little feet. None of these athletes had problems. They were just unique.
However, if the high exercising heart rate is unusual for you then you may indeed have a problem. But let’s further define “high” here. There are going to be days when your heart rate rises above what you normally see by perhaps 10 bpm or slightly more just because of fatigue, overreaching, overtraining, too much caffeine or similar product, or a hot day. This is not unusual at all. You may need to back off and slow down or even abandon the workout that day. This happens to everyone from time to time.
But if your heart rate is well above 10bpm over what you normally see at a given power, pace or perceived exertion (which may not work in this case) then you could have a health problem. But first check to make sure your heart rate monitor is working correctly and there are no errant signals.
Such an unusually high heart rate happened to me in 1994 while running a half marathon. Of course, as the dummy I am, I finished the race, albeit at a slower pace. After weeks of testing my doctor finally determined it was a case of viral myocarditis. That cost me seven months of training.
Another condition to be aware of is atrial fibrillation (“a-fib”). I won’t go into detail on this as you can read more about this here on Dr. Post’s blog.
So if you mean a “high” heart rate as one high relative to what you normally see at an otherwise common intensity and you’ve ruled out the heart rate monitor as the source of the “problem,” then see your doctor.
John Post, MD:
Joe and I have received a number of queries recently about heart rate related issues observed in training so I thought a review may help answer some of these. This is a pretty broad topic so I’ll try to be brief. Let’s try to work from the answer backwards:
1) No two of us are the same.
2) No two of us fit the exact same formula/parameters relating heart rate to training.
3) If I see an unexpected indication, am I symptomatic?
“Balderdash,” you say. You’ve memorized the Triathlete’s/Cyclists’s Training Bible, understand the Borg scale of perceived exertion, and have constructed reproducible training zones. One initial fact that surprises many is that although your “athlete’s heart” resting pulse is probably around 60 or below, according to the Mayo Clinic, a normal resting heart rate can be 60 – 100. Yes, 100! And those of you on beta blockers as a part of your hypertension regimen will note a modest lowering of your natural base rate.
We athletes as a group pay a lot more attention to our bodies in general and HR in particular. And as such we should be familiar with the factors, in addition to exercise, that can modify our expected read out. Examples would be lack of sleep, fever, dehydration, anxiety, coffee (which you already know and manipulate), stress, general state of rest, just to name a few. Each of these could significantly alter that old Polar.
So, if you’re out on a routine training run over familiar territory you see a reading of 220, what do you do?
1) Use the old formula, 220 minus your age, and determine that you are dead?
2) Start self CPR?
3) Flag down a passing motor vehicle for a ride to the hospital?
4) Panic, wonder if your affairs and will are in order?
5) Call 911?
6) Rush home, post the symptoms on an internet forum and wait for guidance from an anonymous source?
7) Stop, think, and reasonably evaluate the situation?
Let’s use the scientific approach. If you’re symptomless, there’s no rush to do anything. An old saw from medical school is when you encounter an emergency situation, “Take your own pulse first.” If you’re not dizzy, in pain, feeling weak – especially on one side of the body, confused, etc. you have the ability to rationally evaluate what’s going on and exercise common sense.
It’s not uncommon to see what seems like bogus information be indeed bogus. Was this erratic reading due to nearby electrical interference, overhead power lines, nearby welding, lead placement or slippage, etc.? It’s unlikely that even if you were running with Kim Kardashian (ladies with Johnny Depp) that you could generate a heart rate of 220.
If, however, you do experience symptoms, or if it happens again, seek medical attention.