AF and breathlessness: I had an appointment... - AF Association

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AF and breathlessness

Heathreb
Heathreb

I had an appointment yesterday with a Cardiac Consultant. I had a echocardiogram and ECG first and a monitor fitted back in July for 12 hours. I have been suffering with breathlessness on climbing stairs, shopping or any excertion so was hoping for some answers as to why I am like this. I was diagnosed with AF about 2 years ago and I am on Nebivolol 7.5 , losartan potassium. 50 mg. Apixiban and Atorvastatin. I had an angiogram about 1 year ago. I was told that my heart was okay for someone my age, and that my problem is the AF, but he didn't know why I am breathless, and to continue with tablets etc. I am confused as thought AF caused this.

34 Replies
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Hi There,

I too am suffering from breathlessness exactly the way you are.I am in "permanent AF. I had stents put in about 4 years ago and I am on losartan, metoprolol,atorvastatin, clopidegral, warfarin - I have just turned 70 and I am in the process of checking out why I seem more breathless than I used to be . I was told it is probably the result of the Metoprolol but will investigate further and let you know if I find anything interesting.

Cheers Sparky

Heathreb
Heathreb
in reply to sparkynz

Thankyou would appreciate any information which would help this problem.

spetho2001
spetho2001
in reply to sparkynz

I am here. I have mild High Blood Pressure that was under control 120/60 ish with Losartan 50 MG and HCTZ 12.5 MG. I went for a physical in Dec and some of my blood test number were a little off and they seemed to be the ones that had to do with the kidneys (BUN, eGFR, HGB, MCHC, BASO%. I called my cardiologist and she and my PCP said my test looked fine. I was still worried so my cardiologist said it was OK to stop the HCTZ as I thought this effected my kidneys. I did not take into account that the Losartan effects the kidneys also. After stopping the HCTZ I was really light headed and short of breath. A month and a half went by and I am back on the HCTZ and I believe I feel a little better. My weight went down a little in this time (purposely). my BP during the time I was off the HCTZ went up to 130-140/70-75.

Anyone have this problem?

Metoprolol causes light headedness and you can pass out. It slows your heart down.

Thank you, TomS

hi there,

I have the same issue every single day. I only need to walk a few steps with the dog and I'm very breathless. I'm on bisoprolol, flecainide, losartan (I also take exemestane . Breast cancer in2015)

It's no fun and so far I'm getting nowhere with seeing my cardiologist mainly because he has such a backlog of patients more worthy than me it seems. I've been waiting since MAY for results of the last 24 hour tape. In the meantime I try to use breathing exercises for it all, not easy when you're so breathless anyway.

Stay well,

Blue :-)

Polski
Polski
in reply to nikonBlue

Bisoprolol is known for making one very lethargic. Your own GP can probably decrease the dose slightly for you. It is worth asking if he is willing to, and see if that helps.

My money would be on the Bisoprolol. Maybe the dose is too high for you or perhaps you just don't get on with it like many here.

I am here. I have mild High Blood Pressure that was under control 120/60 ish with Losartan 50 MG and HCTZ 12.5 MG. I went for a physical in Dec and some of my blood test number were a little off and they seemed to be the ones that had to do with the kidneys (BUN, eGFR, HGB, MCHC, BASO%. I called my cardiologist and she and my PCP said my test looked fine. I was still worried so my cardiologist said it was OK to stop the HCTZ as I thought this effected my kidneys. I did not take into account that the Losartan effects the kidneys also. After stopping the HCTZ I was really light headed and short of breath. A month and a half went by and I am back on the HCTZ and I believe I feel a little better. My weight went down a little in this time (purposely). my BP during the time I was off the HCTZ went up to 130-140/70-75.

Anyone have this problem?

Thank you, TomS

I found it really frustrating to be told by my specialist that he didn’t know what was causing my breathlessness. He did give me a stress MRI to find out but that showed nothing except my heart was sound.

My GP has always felt the atrial flutter and symptoms were caused by my hiatus hernia and acid reflux. I told the cardiologist this. but he was only interested in curing my atrial flutter and absolutely not in finding out what was causing it. My GP said that this lack of interest in the whole person was one of the biggest weaknesses in the NHS system. It seems really wrong to me.

I was wondering if you, too, have acid reflux problems? My breathlessness can still come back even though my flutter has been fixed and I’m no longer taking any tablets except rivaroxaban. I’m a teacher and if I read out loud for long, I start to get it. It’s a weird feeling.

Steve

DIB69
DIB69
in reply to Ppiman

I am convinced of a relationship between acid reflux, gerd and other similar conditions to AF and atrial flutter. There are a number of articles on line which refer to the link as well as references in medical papers. My AF symptoms along with breathlessness are always worse when I have digestive problems.

Ppiman
Ppiman
in reply to DIB69

Thanks. I’ve seen those studies and I’m sure you’re right. The cardiologist I saw, though, said he’d never heard of such a connection - and he was, in every way, a good doctor. I was left mystified by his lack of interest in the cause of the arrhythmia. Fixing it with an ablation was all that interested him.

Steve

spetho2001
spetho2001
in reply to DIB69

I am here. I have mild High Blood Pressure that was under control 120/60 ish with Losartan 50 MG and HCTZ 12.5 MG. I went for a physical in Dec and some of my blood test number were a little off and they seemed to be the ones that had to do with the kidneys (BUN, eGFR, HGB, MCHC, BASO%. I called my cardiologist and she and my PCP said my test looked fine. I was still worried so my cardiologist said it was OK to stop the HCTZ as I thought this effected my kidneys. I did not take into account that the Losartan effects the kidneys also. After stopping the HCTZ I was really light headed and short of breath. A month and a half went by and I am back on the HCTZ and I believe I feel a little better. My weight went down a little in this time (purposely). my BP during the time I was off the HCTZ went up to 130-140/70-75.

Anyone have this problem?

I am sort leaning towards a relationship between Losartan and breathlessness and light headedness.

Thank you, TomS

nikonBlue
nikonBlue
in reply to Ppiman

Hi, I don't get acid reflux thank goodness so that's one thing less to aggravate things!! Bx

nikonBlue
nikonBlue
in reply to Ppiman

hi,

I thankfully don't get acid reflux and am lucky in that department. This breathlessness seems to be getting worse but I now have an appointment on the 3rd Feb with my cardiologist....at last so I'll discuss it with him. I just want to be able to walk along a corridor without needing a paramedic!!!! That's how it feels sometimes :-(

stay well,

Blue x

Ppiman
Ppiman
in reply to nikonBlue

I would ask your cardiologist whether your heart has been weakened by the arrhythmia and if this is what is leading to breathlessness. If you've had an echo-cardiogram, the doctor will know the "ejection fraction" which is a measure of the heart's pumping ability and they will also know whether the valves were functioning adequately.

I feel pretty certain from my own experience of atrial flutter that different people react very differently to the effects of a lower ejection fraction but I have also come to think that anxiety and panic play some kind of role, possibly a very major one, in the effects created by the arrhythmia.

Steve

nikonBlue
nikonBlue
in reply to Ppiman

hi Steve,

Anxiety etc for sure adds to the mix of cause. I've to arrive early for the appointment as I've to have an ECG before I see the cardiologist so yes, I will even write down my questions and ask. Thanks for this!

stay well

Blue :-)

Ppiman
Ppiman
in reply to nikonBlue

Hi - an ECG will show whether you have an arrhythmia but won't show the efficiency of the heart muscle or the valves as such (so far as I understand it). You'll need an echo to show this (or a cardiac MRI, best of all).

Best of luck!

Steve

My breathlessness seemed to be caused by fluid retention and my diuretic intake was increased so I am now taking Carvedolil 50mg, Furosemide 40 mg, Spironolactone 25mg, Riveroxaban 20mg, Candesartan 32mg for AF and HF. I also recently had a CRT -p implant. I don’t get as breathless as I used to on this regime although am not happy about all the meds.

Grayjay
Grayjay
in reply to Crystalbowl

Glad to hear that your implant has improved your condition. I'm currently waiting for an Ablation and possible ICD/ Pacemaker. Soon I hope.

Crystalbowl
Crystalbowl
in reply to Grayjay

Good luck and hope it is soon. I am not sure the pacemaker has made much difference actually. I think it is the diuretics but it may be helping. I go to the hospital tomorrow for the 6-week check up so will see what they say. I do still get some breathing issues but not as bad as they have been.

I always assumed that breathlessness was the result of less oxygen than the body needs, getting around it, for whatever reason. Any comments?

Ppiman
Ppiman
in reply to Polski

I think there are different kinds of breathlessness myself - one kind is a lack of oxygen as you say, but also panic syndrome can create a feeling of lack of oxygen. I feel sure also that diaphragm / vagus nerve issues can cause similar feelings linked to hiatus hernia.

Steve

Hi Heathreb, having had some problems with breathlessness I'm wondering whether some degree of gluten intolerance could be making matters worse. I've found that cutting out bread completely has had a noticeable effect on my energy levels. Worth trying.

Heathreb
Heathreb
in reply to Jalia

Thankyou will try anything to be able to function without getting breathless. I am not a great bread eater but tend to eat cracker biscuits.

It's probably the beta blocker causing your breathless

Heathreb
Heathreb
in reply to Mikee69

Thankyou everyone for your replies. I was quite despondent when I left the hospital after my appointment, which I had waited for since April. I didn't expect miracles but thought there might be an explanation for this breathlessness. I wonder if it would be worth trying to see an electrophysicist , has anyone tried doing this.

Mikee69
Mikee69
in reply to Heathreb

Yes, after two weeks stuck on a cardiac ward under the care of a cardiologist and still in AF with a HR of 195+ I finally got to see an ep.

It changed my life for the better.

Ablation, no more AF , no meds especially beta blockers

Here is a way to reduce the severity of your Afib, or even prevent it from happening:

--------------------------------------------

After 9 years of trying different foods and logging EVERYTHING I ate, I found sugar (and to a lesser degree, salt – i.e. dehydration) was triggering my Afib. Doctors don't want to hear this - there is no money in telling patients to eat less sugar. Each person has a different sugar threshold - and it changes as you get older, so you need to count every gram of sugar you eat every day (including natural sugars in fruits, etc.). My tolerance level was 190 grams of sugar per day 8 years ago, 85 grams a year and a half ago, and 60 grams today, so AFIB episodes are more frequent and last longer (this is why all doctors agree that afib gets worse as you get older). If you keep your intake of sugar below your threshold level your AFIB will not happen again (easier said than done of course). It's not the food - it's the sugar (or salt - see below) IN the food that's causing your problems. Try it and you will see - should only take you 1 or 2 months of trial-and-error to find your threshold level. And for the record - ALL sugars are treated the same (honey, refined, agave, natural sugars in fruits, etc.). I successfully triggered AFIB by eating a bunch of plums and peaches one day just to test it out. In addition, I have noticed that moderate (afternoon) exercise (7-mile bike ride or 5-mile hike in the park) often puts my Afib heart back in to normal rhythm a couple hours later. Don’t know why – perhaps you burn off the excess sugars in your blood/muscles or sweat out excess salt?? I also found that strenuous exercise does no good – perhaps you make yourself dehydrated??

I'm pretty sure that Afib is caused by a gland(s) - like the Pancreas or Thyroid - or an organ that, in our old age, is not working well anymore and excess sugar or dehydration is causing them to send mixed signals to the heart - for example telling the heart to beat fast and slow at the same time - which causes it to skip beats, etc. I can't prove that (and neither can my doctors), but I have a very strong suspicion that that is the root cause of our Afib problems. I am working on this with a Nutritionist and hope to get some definitive proof in a few months.

Also, in addition to sugar, if you are dehydrated - this will trigger AFIB as well. It seems (but I have no proof of this) that a little uptick of salt in your blood is being treated the same as an uptick of sugar - both cause AFIB episodes. (I’m not a doctor – it may be the sugar in your muscles/organs and not in your blood, don’t know). In any case you have to keep hydrated, and not eat too much salt. The root problem is that our bodies are not processing sugar/salt properly and no doctor knows why, but the AFIB seems to be a symptom of this and not the primary problem, but medicine is not advanced enough to know the core reason that causes AFIB at this time. You can have a healthy heart and still have Afib – something inside us is triggering it when we eat too much sugar or get (even a little) dehydrated. Find out the core reason for this and you will be a millionaire and make the cover of Time Magazine! Good luck! - Rick Hyer

PS – there is a study backing up this data you can view at:

https//www.cardiab.biomedcentral.com/articles/10.1186/1475-2840-7-28

And Oh - if you find that your sugar threshold is lower than 50 grams a day - it's nearly impossible to eat less than that each day, which will keep you in permanent Afib. If this is the case, try going to a Nutrition Response Tester. I am doing this and she has improved my gland processing such that we have increased my sugar threshold from 48 grams a day to about 75, which is high enough to stay under - and keep afib from happening (unless I indulge in a sweet something – which I do too often). Hope this helps.

Heathreb
Heathreb
in reply to sugarisit

Thankyou for your reply, will try and cut out my sugar intake, I have been eating more cake biscuits etc. As I lost weight and have been trying to put some weight on again. My salt intake is low as I don't use salt at all only what is in food that you buy, as I have had High Blood Pressure for years and stopped using salt.

Hi Heathreb

I am a great believer in walking. On a Monday try and find a flat path and see how long you can comfortably walk along it and back, repeat again on a Wednesday and then again on Friday. If you can make it a regular pattern of it you should find that it becomes a bit easier as your muscle tone improves.

Having said that bisoprolol seems to get a very bad reputation for breathlessness - other beta blockers are available?

Heathreb
Heathreb
in reply to Ianc2

Thankyou for your reply. Unfortunately the road I live in isn't flat, has quite a slope. The problem being I broke my hip about 11 months ago and still struggling. Perhaps I will try and take the car to somewhere flat and have a walk. I have been to physio but the workout was quite strenuous and made the AFib worse. I'm okay in the house until I go upstairs, but will try and persevere as don't want to be breathless all the time.

Ianc2
Ianc2
in reply to Heathreb

I am fortunate in that I live near a couple of disused railway lines that have been turned onto footpaths. If you get a couple of walking poles you might ease the strain on your hip and help you back into a natural rhythm.

Take it nice and easy start with, but make it as regular as you can. Unfortunately most of us lose muscle mass steadily as we get older and the only way to keep your flexibility is to keep on moving. 6 years ago I could barely walk 6 steps without stopping for a blow. now I can manage about 6 miles. Have a go?

I get breathless with my AF. Has any one suggested a cardioversion or ablation? I am 76 and was diagnosed just over 2 years ago. I had a successful cardioversion which kept me in sinus rhythm for 11 months and I knew i had gone back into AF because I was breathless in bed at night. I had another cardioversion whilst waiting for an ablation which unfortunately only lasted 2 months this time but during those two months I had a total knee replacement and the pain and stress of the recover put me back in AF. I am seeing the Electrophysiologist about an ablation in January. As I am still recovering from the knee replacement I don't really want the ablation too quickly so quite happy to wait and I may have the cardioversion before the ablation.

I used to be on Losartan but stopped it because the FDA had said this drug might cause Cancer. Look where your Losartan was manufactured, China is a big one that marketed Losartan. They said the drug had rocket fuel in it. You have to look up a lot of your drugs to be truly safe. The doctors don't keep abreast on them They gave me Losartan and trimeterene together and I fell in my home and hit my head, I was on on the floor for 5 days by the time my neighbor found me. I was in renal failure and almost died . I have to be very careful because of having a number of doctors. I have RA and Kidney disease and many other problems I won't list

I'm also going on 76 years of age

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