Cardiac Issues with ADT

[Pianodude]

After my 1st year on ADT (Firmagon), I started having cardiac issues (heart attack, low ejection fraction, stenting for a clogged artery in May 2021). We switched to Orgovyx in August 2021 and added Nubeqa in January 2022. I had been feeling OK up until about 3 weeks ago. My breathing is wrong. I am exhausted. My appetite is terrible. I feel like I can't get a full breath today. Last week I was at a doctor's office for something else. My O2 level was 96, which is OK.

I wonder if taking a break from ADT might be a good idea. My PSA is undetectable. I am just not sure if cardiac issues can be reversed. I am already on Entresto, Plavyx, Metrotoprol, and a water pill for the cardiac stuff. I don't know what else they can do.

I never had any cardiac issues before last year.

[Tall_Allen]

What does your cardiologist say about your shortness of breath?

[Pianodude in reply to Tall_Allen]

They gave me a prescription for Lasix. My wife called the cardiologist a little bit ago and they want me to head to the ED and get checked out.

[timotur]

ADT is associated with prolonged QTc interval which can lead to arrythmia. The question is what to do about it. Talk to your cardiologist and refer him to these papers. Some simple things to do are hydrate and make sure you are getting enough electrolytes. Best--

A prolonged QT interval is an irregular heart rhythm that can be seen on an electrocardiogram. It reflects a disturbance in how the heart's bottom chambers (ventricles) send signals. In a prolonged QT interval, it takes longer than usual for the heart to recharge between beats.

mayoclinic.org/diseases-con...

ncbi.nlm.nih.gov/pmc/articl...

[Benkaymel]

I am prone to heart arrhythmias and am concerned about how I'll react to ADT (and AR). I think most importantly you need to do regular aerobic exercise that increases your heart rate, drink lots of water and eat a healthy plant-based diet. But as others say, consult with your cardiologist.

[tango65]

If you are having shortness of breath you should go to the ER and be evaluated. The meds seem OK for your situation. Get checked at the ER to be sure you are avoiding further harm to the myocardium.

[London441]

How much do you exercise and what kind?

[Shamrock46]

My husband also has cardiac issues and takes a low dose statin, carvedilol, Furosemide and Losartan....as well as Lupron and 18 mos. of Enzalutamide for PC recurrence. He was taken off the Enzalutamide 2 wks. ago after experiencing severe weakness in arms/legs and increased shortness of breath. It has similar side effects to cardiac issues so I moved his annual cardiac echo from end of year to this week so both cardiologist and MO can evaluate. Echo showed he now has pulmonary artery hypertension...his regular cardiologist is out of town and waiting to hear from one of his partners about those results. At the same time he started having these worsening side effects, his PSA started going up slightly...we have an appt. w/MO in 2 wks. to discuss options for further treatment. He's already refused biosphosphonate therapy because he's prone to SE and doesn't want jaw necrosis. He also doesn't want anything else that has more cardiac implications which will make for difficult decisions. Best of luck with your treatment!

[Pianodude]

Update: As it turns out I have a pulmonary embolism. In the hospital right now.