Symptom/side effect/other

[nivek]

I am attempting to obtain information/experiences from the community as I am unable to categorically determine the reasons for my concerns.

I am Male 70 yrs. recently diagnosed with Angina and AF; other than breathing difficulties during moderate/extreme exercise I have no symptoms at all, no chest pains or palpitations, my condition has been classified as ‘nothing worrisome’ which is great. I therefore consider myself very lucky and believe I fit into a category whereby a great number of patients have been diagnosed with Angina and AF and provided with (similar) appropriate medication.

I was already taking long term in the evenings with no food

Candesartan 32mg

Rosuvastatin 5mg

My Cardiologist prescribed medication to be taken in the mornings with food

Aspirin 75mg

Monomil XL 60mg

Bisoprolol 1.25mg

Unfortunately after a number of months I became more and more jittery and concerned on a daily basis, with muscle aches in my shoulders, neck and jaw, it was a ‘none specific’ feeling of foreboding and best described as just feeling ill (which I understand is not helpful in a diagnosis) but best describes my overall and ongoing symptoms.

I made my Cardiologist aware of my condition and subsequently medication was changed by substituting Angitil SR 90 capsules (twice daily) for Bisoprolol 1.25mg. Initially this change made a profound effect on my well-being however within a month I began to suffer from neck and shoulder pains; because I was on a long term prescription of Rosuvastatin 5mg. (which may give such side effects) my GP agreed to suspend this drug to see if there are improvements.

It has been a Month since this recent change and unfortunately my overall well-being has deteriorated with pains in my arm muscle joints as well as an overall feeling of dis-ease once again resulting in a poorer quality of life

The AF Association has a factsheet ‘How long should I take a particular medication before trying another, if it is not controlling my symptoms or if it is producing side effects’, whilst this explains policy and procedure I am able to find out what individuals may specifically suffer from on an hourly/daily basis and if they are similar to myself.

Prior to my diagnosis I felt well and happy and it therefore it would be reasonable to assume the following as an explanation;-

1The medication prescribed is not being well tolerated, the changes made have not resulted in the desired effect

2There is some other medical problem causing these symptoms

3Psychosomatic self-induced symptoms

I would appreciate comments, observations and experiences from the community as I am sure I am not the only person to have these symptoms and any answers may assist others suffering similar.

[mjames1]

First and most important, I am not a doctor nor have no medical training and your issues have to be addressed by a doctor.

That said, sounds like the issue was not the rouvastatin and hopefully your doctor put you back on it.

However, my understanding is that neck, shoulder and jaw pain can be symptomatic of angina. So my non-medical thought is that it may not be the drugs, but rather the angina causing those symptoms. I also believe that they can do a differential diagnosis for angina using nitroglycerin tablets. If the symptons go away after ingesting, then points to angina. If not, maybe something else.

You should really have another talk with your doctor and if you feel that your concerns aren't being met, get a second opinion.

Jim

[BobD Volunteer]

Just to add to what Jim has said I agree regarding the angina being a possible cause which was my first thought. A GTN spray tends to be more instant than tablets in this regard.

What concerns me far more is the aspirin and no apparent anticoagulation. Since you are taking candesartan ( a blood pressure med) and you are over 65 your CHADSVASC score is at least 2 and with AF you should be anticoagulated for stroke prevention. I would also think that some tests such as echocardiogram or angiogram should be on the cards to assess the plumbing side of your heart if you have not already had these.

Edited.

Diltiezem ( generic name for angitil) is a calcium chanel blocker rather than a beta blocker so whilst it does the same job as bisoprolol many people find it easier to live with.

[Hidden]

This sounds like a tricky issue. One thing which might make a difference would be to ask to be switched to a different stain-some statins are more likely to be cause the symptoms you describe than others. Also, there might be an alternative to Bisoprolol which many here have said has caused side effects.

I have PAF and am under investigation for stable angina which is "suspected" although it could be costochondritis. . I wanted to ask if you ever get chest pains when there is no exertion, e.g. in the morning g when lying or sittin? Also if there is any tenderness when you press on the area where the pain is emanating from? Finally, is ordinary walking sufficient to induce the pain after a few hundred yards?

[Singwell]

Something to add to the mix. Your heart contains many thousands of its own neurons that - like the 'gut brain' - sends messages upstream to the brain. This is why some if us feel a profound sense of unease during AF episodes. Even though there's nothing to be measured. You might be experiencing this. The other thing that occurs to me is you might have anxiety. Anxiety manifests in the body as well as the mind and its surprising how many symptoms it can cause. So these are not psychosomatic - they're manifestations of anxiety - a real condition. Aches, pains, tingling, digestive issues,etc. These are just a few. I personally experienced stress related vertigo and tingling with anxiety as well as fast breathing and jaw tension. Do a bit of digging around this area with a professional. Found out about these manifestations btw from an online conference rum by AF Association last year. Hope this helps.

[CDreamer]

Just point out that Bisoprolol is also an Adrenaline Blocker and can cause some of the symptoms you describe but that’s a heady cocktail of drugs you are on so you also need to consider the interactions and how you metabolise these drugs - that’s difficult for your body if you don’t take with food as the body is able to determine what is food and nourishment and not.

There are some drugs that need to be taken on an empty stomach but please determine which and try taking others at different times and with food?

You’ve had some really good, intelligent replies but I’d just like to pitch in to the idea of Psychosomatic. Somatising emotion is not something to be dismissed as ‘it’s all in the mind’. Singwell makes some excellent points - if you have AF you will experience symptoms of anxiety because that’s your body trying to communicate with you that there is something wrong. If you can meditate and take the position of Enquiror and Observor you can learn a lot by just focussing in on what’s going on when you experience these symptom

You cannot separate mind and body, they work as one unit and if you are experiencing symptoms then you need to listen to your body because it’s trying really hard to communicate something to you. Much more difficult is to interpret the message, but focus hard enough and you can find answers. Listen to your body, it’s far more intelligent than your mind which is far too egocentric.

Sorry there is no simple answer to your question but my simple rule is take as few drugs as is absolutely necessary and agree with Bob - anticoagulants not asprin would be my first change. I would also question the need to take some of the other drugs on your list.

[Buffafly]

I sometimes get angina pains in my neck and jaw. My guess would be that sometimes your HR is speeding up a bit and this, combined with AF is causing the feelings of discomfort. Another (also ‘worrisome’) possibility is that the aspirin is causing stomach area pain radiating to your shoulder. I would want to know why aspirin is considered more appropriate than an anticoagulant. Your cardiologist sounds rather ‘old school’ (trying to be polite) and I would want to see someone much more proactive as 70 is not considered very old these days and it’s a bit early to tell you to live with the condition which is basically what he’s done.

I think it’s time to change your cardiologist?

[Buffafly in reply to Buffafly]

PS I should have said that if you get increasing pain in neck and jaw radiating down your arm together with generally feeling ill you should call either 111 or 999 depending on how bad you feel ❤️‍🩹

[CDreamer]

Exactly - it’s an irritant to the stomach and doesn’t protect against strokes caused by AF so no win or gain from taking it for purely AF. It does have place for many other cardiac issues though where an anti platelet rather than anticoagulant is required.