Q: Under what circumstances is the heart rate of a person, more in supine state than in exercising state? Is it possible for a normal person to have supine heart rate more than the exercising rate and that too after a span of few seconds from supine to exercise state?

A:Supine heart rate more than exercise rate is most unusual in a healthy person. It is always lower. Such a response, which if reproducible, indicates a problem unless proven otherwise. It can be possible because of autonomic neuropathies or release of catecholamines in a surge during supine posture in some unusually laced tumours etc. Exercise inducing ischaemia due to diseased coronary arteries can lead to slowing of heart rate especially in situations of right coronary critical disease. Any person having this response needs a thorough evaluation.