Hello, i have been checking out this website for a month now after my Mum was diagnosed with AF after a GP check up. She went to the doctors and knew her heart was jumping. The doctor took her BP which was very high ( she suffers with BP but also white coat syndrome, she is also on BP medication) which makes matters far worse. The GP performed an ECG and told her she needed to go to hospital as she was at high risk of a stroke. The GP sent a no emergency ambulance some 4 hours later and the paramedics took her BP (184/90) and did another ECG enroute to hospital. She was in hospital overnight where they monitored her BP (which they said was perfect) her bloods were checked and all other tests which were positive. She left at 10am the next morning with Apixaban medication.
She felt fine for a few days and then went back to the doctors for a check up, her BP was high again (although it was perfect in hospital the hospital had not sent the information across to the GP) so the GP put her on Bisoprolol which gave her the worst side effects ( tiredness, feeling depressed etc) my mum was a shadow of her former self on these so the doctor agreed she could stop taking the Bisoprolol if it was making her that unhappy. She is also taking Spironolactone as well as a water tablet. I do have a few questions I would like to ask the experts as I personally don't have much faith in the knowledge of the GP on subject of AF.
1. The medication she is taking seems to be having an adverse affect on her stomach, she has bad stomach acid which is a lot worse since the AF diagnosis. CAn anyone shed any light here please?
2. Which is the most important medication for her to take with AF?
3. She is still suffering with the racing heart but it always seems to come on in a morning after she has taken her medication and slowly gets better through out the day, again can anyone help here?
4. She is waiting for an appointment with a cardiologist, but appointments now being made for end July, with no date in sight yet, can she request her appointment is with a specific specialist who specialises in the electrics of the heart?
5. Finally, a question to put my mind at rest. When mum tells me her heart is racing I worry so much she will have a stroke, will the blood thinner help prevent this, and how do you know if the media she is taking are working?
Many thanks in advance and sorry for the long message x
Sorry forgot to mention on post above. Because my mum has been suffering with her stomach since the AF diagnosis she is barely eating anything and just sticking to very basic foods as she is worried that diet is bringing on the AF episodes.
It is very strange as when her stomach is bad I check her pulse and you can feel the irregular beats. When her stomach is OK her pulse is regular and around 64-70 beats per minute.
Welcome to the forum, and it's great that you are so involved with helping your Mum, it will make a big difference.
ok DEEP BREATHS, the first thing to remember is that awful though it is, AF is very unlikely to be fatal, it's not a fatal condition, it's ruddy awful and depending on your symptoms can make your life really difficult, but it's not a killer.
You need to find out as much as you can about AF, and the best place to start is the AFA website which has loads and loads of information and some great videos with people's stories, these will make you feel better.
I'm just going to try and answer your questions.
1) Can't comment on the drugs and the stomach we are all different here, and it may be they need to try other drugs.
2) The most important medicine she can take is an anti-coagulant, (not a blood thinner it does not thin the blood and doctors use thios badly to try and explain what it does) The real risk in AF is from stoke, it's around 5 times that of an equivalent person and with an anti-coagulant drops to a little less than twice.
3) Unusual for the medicine to cause a racing heart, this could be anxiety but depends on what drugs she are one, unlikely for the beta blockers, or calciumc channel blockers to raise heart rate
4) Yes she can insist on seeing an EP (Electrophysiologist) but the waiting time could be lomger, do consider paying for the first appointment, might costs around £300 but well worth putting your mind at rest early, and then she can drop back to NHS.
5) There is no real connection between the heart racing and stroke, well sort of not. AF means that the upper chambers of the heart (atria) are beating really fast when in AF but the signal to the lower chambers (ventricles) is not working well and the ventricles are beating sometimes faster sometimes lower (Ventricles are where heartbeat is measured) The stroke risk come from the upper chambers particulalry the left atria, but is not connected directly to heartrate.
5a) How do you know if Apixiban is working?, there is no blood test available to doctors to check it, unlike warfarin where you can measure INR. Suffice to say that there is lots and lots of research which shows it to work almost immediately after taking the tablets.
Be well
Ian
Thank you Beancounter that puts my mind at rest.
I guess the stomach issues are down to her stomach not being able to tolerate some medications and I guess just trial and error to find one that suits. Again I don't think the GP is that knowledgable.
I will call the hospital tomorrow and request the EP I would like her to see and hope the hospital adhere to these wishes.
Thanks again, but I am sure I'll be back with more questions x
Ian says it all but just to add one thing. I suspect the stomach issues are the Apixaban. I'm not on it myself so maybe one who is can comment. There are ways to help this matter.
Just to add to what Ian has said I suspect that the stomach issues are down to the Apixaban . Since I'm not on this drug maybe one who is can comment. on ways to help.
There are some possibilities that the AF IS related to stomach issues through the vagus nerve which is a very large nerve - commonly known as the wandering nerve - which runs very close to the heart and the stomach. Many people find that certain postural positions can trigger an episode - especially during the night, lying on one side or another, after exercise, after consuming a large meal etc, etc.
As everyone is different what works for one person is a trigger for another so very difficult to say.
Anxiety will also exacerbate any and all symptoms and AF anxiety is unlike any other anxiety I have ever encountered and physiological as the vagus nerve is also part of the autonomic nervous system - the fight or flight response so anxiety comes with the territory.
Stomach upset could also be a symptom of the drugs (don't know about Apixaban either) or it could be something entirely unconnected to AF, vagus nerve or drugs and for that reason it is a good idea to exclude any other cause by seeing your GP. Try to establish exactly what symptoms she has, at what times etc and at what times she takes her meds and with what. That may help to narrow the field somewhat.
I found I couldn't take my anticoagulant - Dabigatran - if I ate bread or toast as it gave me dreadful heartburn for instance. If I took with a homemade smoothie, I was fine. By the way, if she has no appetite then smoothies and soups are a good way of getting enough nutrition which is easily digestible and smoothies you can just take small sips. Just be very careful about the bought varieties as they can often contain too much sugar.
My recipe is based on watermelon (neutral Ph), Apple, 1/4 peeled lemon, 1/4" of peeled root ginger, coconut water and whatever green leafy veg is in the fridge. I also add milled nut&seed mix and sometimes a banana or an avocado, but you can add yogurt. This would replace a meal such as breakfast or lunch.
Whenever I have had stomach and gastric issues I have found that sipping hot water has really helped, sounds weird I know but it really works!
Some people do have food triggers but the only way to really know is to keep a very accurate food/symptom journal but common suspects for AF triggers are:- coffee, alcohol, tea, nightshade veg eg- aubergines etc.
You don't say whether or not your Mum's not eating is because she has no appetite or because she fears if she does, it will bring on an AF episode, if the latter may I suggest eating lots of very small amounts rather than 3 meals a day as a full stomach can trigger an episode. If it is the former, then go back to the GP for more investigations as it could be completely unrelated to AF and just a coincidence that they appeared at a similar time.
The other issue to address is the anxiety and may I suggest a breathing exercise which is known to help anxiety and also can help slow heart rate - it requires practice so would help if you could master it and you practised together so she could mirror your breathing - this really helps. Slow your breathing by breathing in to a count of 7 - this means you have to use your diaphragm to push into your belly to really fill your lungs, hold for a sec then breath out very slowly for count of 11. If you can't manage that at first try 5 and 7 breathing - the important bit is to breath out for longer than you breath in and to slow your breathing, I find closing my eyes helps me to focus.
The drugs for AF are
1- Anticoagulation - which she is on so she will have some protection against the biggest risk factor - AF induced stroke
2. Heart Rate drugs such as Bisoprolol which often come with unwanted side effects such as your Mum experienced but there are other heart rate drugs which you/she could discus with cardiologist or EP,
3. Anti-arrythmic drugs which also carry side effects - there is plenty of info on the AFA website - go to the Publications tab and you will see booklets you can download or you can order printed copies. All are clearly explained there with all the names of the drugs and what they are,
Don't hesitate to ask any questions, usually someone around to help but I always think it is worse for the person watching than the person experiencing the problem, you feel so helpless!
I take all my meds with food, unless stated not. I jus feel it lessens some of the side effects. Rivaroxaban definately must be taken with. I know Apixaban has had problems and thee are lots of posts on here of how people have overcome these problems. You say she is on Spironolactone and other water tablets ( if that furosemide). I was on Spironolactone for a few months and had to come of them as they were making me tired and spaced out, I felt my funtion was impared and did not driving on them.
Also being on water tablets you should still drink plenty of water, as we with AF seem to get de-hydrated easily and of course taking these does deplete out water levels.
Dear BobD, just curious as to why you think the Apixaban may be causing the hightened stomach problems? Not sure if it's a coincidence but this is the only med she has been on since diagnosis in early May 2016 ( she has swapped he others due to the other side effects) and last week she went for an endoscopy and was diagnosed with a very small Hiatus hernia, she is now on some tablets for this too.
Cassie46, thanks for your reply. She does take them all with food, wheat and gluten free toast as this seems to be the only food she can have a breakfast time. Can I ask your experience of Apixaban ? She is drinking more water too.
CDreamer, thank you to take the time to reply. She does think it's Vagal AF as the racing heart is mostly linked to bad stomach, acid and belching, but the GP does not seem to see a link, she is just dishing out the indigestion medication. She has always had a sensitive stomach and has intolerances to dairy, wheat and gluten but she could cope with the symptoms if she had eaten the wrong food. However, since the AF diagnosis and taking the meds she seems to be worse.
She is not eaten because she worries what will trigger the stomach/AF.
Drinking Hot water does help a little.
Bisoprolol , she came off this as it was causing tiredness and making her feel depressed. I really have noticed a huge difference in her daily outlook since stopping. She was literally a shadow of her former self on this drug.
It seems difficult to get cardiologists and doctors to agree a trigger being digestive problems and vagus nerve . It is in my case and bloating also puts my BP readings up.
My first AF was after heart surgery and a cardioversion put me back in NSR for 15 months until my vagus nerve was stimulated by the probe during a colonoscopy. Another successful cardioversion but back in AF after my vagus nerve was again stimulated this time by a rectal examination of my prostate. That nerve has a lot to answer for.
I developed stomach problems around the same time as AF. I was on warfarin but changed to apixaban a few months ago. I do not think the warfarin or the apixaban caused my stomach problems but rather that it is related to AF itself.
I have stopped having bread at breakfast time and now have a bowl of fruit with 3 or 4 dessertspoons of natural yogurt. I now rarely get any reflux during the day. I still some times get bouts in the evening possibly related to large meal. It is a huge improvement.
Finally, when she sees an EP, ask about ablation. I had mine done in 2013 and AF free since then. Some say have to try meds first but there is an argument that says the earlier it is done the better. My EP gave me a choice, drugs or ablation as a first line of defence. I chose ablation and was on bisoprolol while I waited. I did not like it as breathless etc.
Best of luck to her and you. 🍀 She is lucky to have you.
Iallym, she has always been a bit stomach sensitive however it got worse when she was diagnosed and started the meds, a few weeks later also diagnosed with hiatus hernia. She will be seeing an EP soon when appointment comes through so hopefully some light will be shed.
She has been have wheat and gluten free toast at breakfast and most lunches as she feels it's the only thing she can eat but that's may be one problem.
Thank you, I am determined to make living with AF as comfortable as possible for her xxx
I see a consultant at a Hypertension Centre. Discussing all the meds that have caused me side effects he said "If you really want side effects try Spironolactone"
Knowing something of his health problems I assumed that he himself is taking it.
Another talking about ever needing my carotid artery reamed out said that he would not be first in the queue for that. I had it scanned recently and although some plaque the blood is flowing freely.
Not well I don't usually notice my AF much but I do today as I have had indigestion and felt very bloated. Went to the Eastbourne Tennis tournament (no travelling, it's just across the road) and felt uncomfortable all the time.
Better since having dinner and BP 139/80 66 and not had a Losartan since Friday after discussion with my GP. I had worsening numbness in my left foot for a year. I stopped Bisoprolol and had some improvement and felt much better in other ways. Losartan can cause neuropathy and neurologist could not pin down a cause. I've had CT and MRI scans and neurosurgeon did not find anything on the scans to concern him so now clutching at straws as I wait to see a neurologist who specialises in neuropathy.
I have developed back pain but that I think is from the way I'm walking at the moment.
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I don't usually notice my AF much but I do today as I have had indigestion and felt very bloated. Went to the Eastbourne Tennis tournament (no travelling, it's just across the road) and felt uncomfortable all the time.
Possible AF
Is it anxiety,tachycardia or Afib?so confused
Af or something else?
Should one asymptomatic and isolated AF episode be medicated?
What happens next please?
