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In regularly active individuals with McArdle disease, they may not feel the usual symptoms of muscle fatigue and cramping until they increase their speed to very brisk walking, jogging, or cycling; however, they will still show an inappropriately rapid heart rate response to exercise, with a declining heart rate once second wind has been achieved.
[17] [32] That said, patients with McArdle disease typically experience symptoms of exercise intolerance before the age of 10 years, [17] with the median symptomatic age of 3 years. [33] [34] Tarui disease patients do not experience the "second wind" phenomenon; instead are said to be "out-of-wind".
In young children (<10 years old) with McArdle disease (GSD-V), it may be more difficult to detect the second wind phenomenon. They may show a normal heart rate, with normal or above normal peak cardio-respiratory capacity (V̇O 2max).
In McArdle's, the highly active AMP deaminase, which additionally experiences amplification from the bloated AMP pool due to the lack of the moderating effect of myophosphorylase, is able to produce a readily observable "second wind" phenomenon almost exactly 7 minutes after a significant load increment.
Now medical experts are suggesting musicians who play wind instruments should clean them after each use to avoid contracting lung disease from micro-organisms.
[7] [9] A 12 Minutes Walk Test (12MWT) can also be used to determine "second wind" which is also seen in McArdle disease (GSD-V) and phosphoglucomutase deficiency (PGM1-CDG/CDG1T/GSD-XIV). [7] [26] A cardiopulmonary exercise test can measure both heart rate and breathing, to evaluate the oxygen cost (∆V'O 2 /∆Work-Rate) during incremental ...
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