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AF & Migraines ? Side effects of medication or What Else ?

kkatz profile image
15 Replies

I haven't suffered from Migraine for years Until recently but have had a few over the last 3 to 4 weeks. Initially sight disturbance & aura for 30 mins max ( no bliding headaches ) , Today all day - no vision disturbance just dull headache , pressure, light headed . I was diagnosed with Paroxymal AF in August & prescribed Adizem August & Edoxaban in September. I have not had anything I would recognise as an AF episode & my BP monitor has not shown any irregular heartbeats . I have also taken pulse manually & no evidence. My bp Diastolic BP is sometimes a little low at around 62 -65 & Sistolic at around 110. As

Any ideas or similar experiences. I am in Portugal at the moment & only returning to the uk for about 3 weeks. Unsure as to how much experience my GP has of AF & unlikely to get a hospital appointment while at home. I may be able to phone my AF nurse specialist on my return.

I dont know whether to worry or just put up with things.

Advice appreciated,

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kkatz
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CDreamer profile image
CDreamer

I had migraines from childhood which mostly disappeared in later adulthood, until AF started 10 years ago. I had 2 ablation 2013/14 during which a PFO was discovered - hole in the heart - to be precise a small hole in atria septum. PFO’s are strongly linked with migraines and about 20-25% of the population have a PFO and most people don’t know they have one. Usually they don’t require any treatment.

I would suggest that if it happens again you should seek medical advice urgently, especially if you are anticoagulated.

There is something called a hemiplegic migraine which can mimic stroke symptoms which may resolve quite quickly whereas a migraine, as I am sure you know, will often last 2-3;days.

Mine did not show on echo or any other scan.

Can’t answer your question about seeing anyone as you would require tests. Could you not see someone in Portugal?

You may find this site helpful

migrainetrust.org/about-mig...

Well, all this might be significant but again, it might not!

A couple of years ago I twice had coloured visual disturbances (one a straight line and the other a crescent moon) that lasted no more than ten minutes and were not in any way connected with an ablation. No headache or lightheadedness. I mentioned these to my GP at my next appointment, and he seemed entirely satisfied that they were just visual migraine auras and nothing to worry about. I have had no more weird colours, but I frequently have a brief shimmering effect almost out of my line of sight.

Casey1225 profile image
Casey1225

I thought I was having silent migraines. The visual disturbances aura but no real headaches. Then I was diagnosed with afib and they said is was a TIA (mini stroke) not a migraine because of AFib. They put me on Eliquis and I was already on Atenolol for a basic irregular heartbeat for years so they kept me on that since it works pretty good for me. TIA's mimic migraines.

CDreamer profile image
CDreamer in reply toCasey1225

And migraines mimic TIA's - just been through that one and after scan, bloods and MRI it was inconclusive which caused quite severe symptoms. Personally I & my GP think it was a TIA for various reasons but as I am on anticoagulants and symptoms - left side weakness, unable to board walk and general feeling of doom - I was discharged after 8 hours of monitoring.

It is very difficult to distinguish but if it is out of your normal sensations I was told to not hesitate to return to have it checked out.

dedeottie profile image
dedeottie in reply toCasey1225

I was just about to write a reply and then saw yours casey1225. I could have written it myself !

I would say that if it happens again KKats ,to get checked out. The trouble is that a TIA doesnt leave any lasting signs so diagnosis of a TIA is often made if the patient has AF. Following my episodes I was prescribed anticoagulants and I have never had anything like it again. Not worth taking chances I say.

Good luck x

An Opthalmist told me that aura are caused by reduced blood flow to the rear of the brain, and should resolve in about 30 minutes. Probably association, but when I had a stroke several years later it affected the rear left side of my brain and I'm now blind on the right hand side from hemianopia.

in reply to

It was after reading your posts Hidden that I told my GP about my visual disturbances.

I think it may be better to seek an opinion than just put up with things but keep an open mind rather than worrying.

JaneFinn profile image
JaneFinn

My experience, for what it's worth ... :)

I started what was diagnosed as migraines out of the blue 2 years ago, first with what might have been a hemiplegic migraine (the stroke mimicking one) followed over time by episodes which vary - sometimes balance disturbance, sometimes visual, sometimes crashing pressure in my head. Dull ache not severe pain. Lasting anything between 20 mins and 3 days.

My BP was extremely high (not low like yours). At a&e they failed to do a ct scan when I went in with the sudden hemiplegic one, but later I had an MRI which came back clear. The neurologist said that it was definitely migraines not TIAs, as that many TIAs would have shown up something on the MRI. (I wasn't convinced, but he sounded certain!)

A year later I was diagnosed with AF, and the Neurologist still says these are migraines. He is about to switch my BP meds to a tablet to treat both the BP and the migraines. Treatment from a cranial osteopath is helping loads. The EP says there's a physiological link between neurological issues like migraine /aura and arrhythmia. Neither seem at all worried!

But the crucial thing for me was that I got it checked out. Now I don't need to worry when these different symptoms hit. Maybe a phone call to talk it through with your home GP now would help? That's what I'd do. Then s/he can advise if you should get seen before you're home?

Do let us know how you're getting on x

kkatz profile image
kkatz

I am on adoxaban . should this not protect me against TIA 's & stroke ?

CDreamer profile image
CDreamer in reply tokkatz

It will help to reduce the risk only, there is no ‘protection’ hence the warnings to get it checked out.

in reply tokkatz

My understanding is that a very brief TIA with full resolution is more typical of a platelet embolus from the carotid or vertebral arteries., than embolus from the left atrium.

Carotid artery ultrasound can pick up important stenosis. An MRI will show the vertebral arteries and Circle of Willis. In this situation, an antipltatelet agent will be considered in addition to AC in patients with AF. I am uncertain whether an anticoagulant alone is sufficient for carotid artery emboli

That said, I imagine that with you being under a neurologist you will already have had these scans if clinically indicated.

I am less certain that medics other than neurologists always consider an extra-cardiac source of embolus in patients with AF who have TIAs.

I am not a doctor but am somewhat obsessed with health issues. The internet is a great source of information but will never substitute for the 12 to 17 year training required for medical specialists, whether in hospital or family medicine.

In my opinion, the most challenging area of medicine is what is termed general practice in a slightly derogatory way. In reality, being a good GP requires a level of expertise, empathy and patience way beyond many hospital specialists. GPs get a fair old bashing here many times. It would be good to hear when folk are very content with their GPs and hopefully restore some balance. We need to have confidence in our doctors.

Sorry, got carried away....bad habit 🙂

Choroba13 profile image
Choroba13

After my cryoablation I had several times a visual aura , amorphous color piece moving in the front of my eyes for 15 minutes without headache. It happened still being in the hospital and doctors stated that it has nothing to do with TIA or any neurological events. It is phenomenon that comes occasionally with Transseptal punctures in the left atrium.

Here is an article about it.

ncbi.nlm.nih.gov/pubmed/195...

kkatz profile image
kkatz

Hi just to update everyone. I got a call back from Arythmia nurse when I was in Portugal. His opinion was possibly migraines & try avoiding triggers .I cut out orange juice as I dont usually have it in the uk. It seemed to help . I only got one more in portugal & 1 when I was home (stress related). Went to seem them yeaterday (not same nurse but very good) . He said sounded more optical . Advised the sort of things to look out for if I had to worry & has now discharged me to GP care. Off to the Algarve tomorrow. As an asside I had a visit to casualty on the 4th . I had a creeping numbness both sides & felt I couldnt swallow. I rang 999 & put phone on speaker. boy was I scared. It resolved itself in arund 5 -10 minutes. I Rang 999 back to say no Panic . I was told at least an hour to wait. hubby took me to A & E . 3 hours wait to be told no idea what could cause this as it was bilateral . Took 10 mins blood test & sent me home. Arythmia nurse put forward some ideas such as BP dropped but again told me not to worry not TIA or stroke related. I think Maybe I panicked & I was literally scared stiff & couldnt move.

in reply tokkatz

Rather than a dropped B/P your momentary paralysis was most likely, the symptom of a spike of high blood pressure. Monitor your blood pressure, usually it goes up while on holidays because we tend to eat foods that contain too much salt (sodium), which increases the B/P. A spike of high blood pressure can happen unexpectly even if your blood pressure has been normal all day. Usually it goes up suddenly and then it comes down back to normal in a few minutes, leaving you momentarily paralyzed and scared.

Medications for AF do not cause migraines, on the contrary beta blockers are often prescribed to prevent migraines. But please make sure you have a true migraine and not other types of headaches that can be something else. Most common triggers for migraines are food stuffs. Those that contain the substance TYRAMINE., for example: 1- Cured and smoked meats, like sausages, ham, prosciutto, salame, bacon, corn beef. 2- Fermented foods or beverages like beer, red wine, aged cheeses (Camembert, brie, swiss, cheddar, blue cheese, gorgonzola), Sauerkraut, pickle hearing, Miso soup, soy sauce. 3- Over riped fruits (bananas, oranges, pineapple). 4- some vegetables like avocados, ripe tomatoes, ripe bananas, broad beans, fava beans, chocolate. You don’t have to avoid all these foods but watch and avoid only the ones that bring up the migraine, then make a list. Every person is different and therefore the triggers can vary.

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