Abfib, low pulse and intermittent chest pain

[Jojasp]

Hi, I have recently been diagnosed with Afib by chance whilst having an ECG at GP. I have bought a Kardia and monitoring my heat rate which has been between 48 to 52.for last fee weeks. My original complaint was chest pain which felt like indigestion. Been to see a Cardiologist who has done an echo cardigram and said overall my heart looked quite good although there were signs of a slight left enlargement and some hardening. However still have intermittent chest pain so waiting to have a CT cardio aniogram. I know people on here aren’t doctors but just wondering about peoples views about whether you can have afib and low pulse rate and whether chest pain is associated with ab fib too. Although a bit anxious about new diagnosis and trying to work out what it means for me and how I can help myself, otherwise feel fine and able to continue with moderate exercise. Thanks in anticipation of any replies and so glad to have found this forum .Jo

[BobD Volunteer]

A Fib can be fast or slow although admittedly it is usually fast. Unless you are an athlete your heart rate is far too slow for normal people (60 to 100 is normal) so will limit what treatment can be given. Yes chest pain is a side effect of AF for some people but MUST be investigated. Sounds like you are being well looked after.

[Teresa156]

Hi Jo,

As Bob said, it sounds like you are being well looked after. Are you constantly in Afib and are you on medication for it now? - I just wondered as yes, your rate is very low and wondered if it was meds causing that? Was it higher before? Were you this low when you saw the cardiologist?

My Afib attacks are always high 150s to 180s but I don’t get chest pain, but like Bob said, some do.

[Jojasp in reply to Teresa156]

Hi Teresa,

Thanks for the reply. I have only knowingly been in Afib twice. Once at GP surgery when he did and ECG and once at home using a Kardia. Heart rate was only 110 and 102 respectively. It only lasted about half an hour or so at home and went back to NSU. Been monitoring at home now for about 3 weeks and seems to range from mid 40s to low 50s. GP did prescribe bisoprol but rate fell to low 40s so he said stop taking it and blood thinners. Cardiologist said to start with blood thinners again because of chest pain. I guess that is why he has asked for CT cardio aniogram. Thanks for info and suggestions. Hope all is good with you - thanks Jo

[Teresa156 in reply to Jojasp]

Hi Jo,

Thanks for coming back…I think I understand a little more now. So you have a heart rate of between 48-52 but that’s not when you are in afib? I hope I’ve understood that correctly.

So when you go upstairs or do things, your heart rate goes up doesn’t it? Is it only 48-52 ish when you’re resting? But this is a new thing? Your heart rate doesn’t usually go this low, only for past 3 weeks and you are only taking an Anti coagulant?

I can understand why the cardiologist took you off Bisoprolol as that can make heart rate really low, what dose were you taking by the way? Sometimes lower doses can be better, but there are also many other meds you can take, though if you are paroxysmal, which is what yours sounds like ( which means it comes and goes) if you get another Afib attack what did your cardiologist say to do? Some people get something called a ‘pill in the pocket’ ( I have that) where you take a combination of a beta blocker which controls your rate, like bisoprolol and/or a rhythm control drug ( if the heart is structurally ok) like fleconaide, which you may read about on here. Both seperately or together can really help to bring you out of Afib quickly, but if your attacks are always short then perhaps they don’t think you need that yet.

As Mav said, definitely try and notify the cardiologist ( perhaps even via their secretary as it’s not always easy) if your pains get worse or if your attacks worsen or get longer.

It’s really understandable that it makes you anxious, I have experienced a lot of anxiety - as have many on this forum and I think it tends to go hand in hand with this condition unfortunately. Deep breathing is always good if you feel your heart rate rising, it has worked for me and many others here, many times.

We can try and find triggers but it can be hard….many are food, alcohol, caffeine and unfortunately stress and anxiety 😳

I had to sadly give up alcohol last year as that might have been one of mine.

I meant to ask too - have you had a full blood test done recently?

Good luck & we are always here 😊

[Jojasp in reply to Teresa156]

Hi Teresa, thanks for your reply. Yes you have understood my symptons. GP ordered blood tests and said they were normal, although Cardiologist said cholesterol was on the borderline of being high. Thanks for the info about the pill in the pocket and the triggers. Since the diagnosis trying to follow a healthy diet, drink plenty of water and exercise 3 times a week. I am still drinking a little alcohol but now drinking mostly alcohol free lager and low alcohol wine. I think I a big thing for me going forward is trying to stay positive and managing anxiety as I tend to over think many things. Hope you are keeping well and thanks for the support Jo

[Teresa156 in reply to Jojasp]

Hi Jo,You are very welcome and I do hope it helps….for the anxiety, I can really recommend ‘Hope and help for your nerves’ by Claire Weeks. Written quite a while ago, but she is excellent. It really helped me when I was ‘at my worst’.

Good luck with everything and I do hope you get further tests etc soon.

Teresa

[mav7]

The echocardiogram should have revealed any possible abnormalities and the cardiologist would have done further tests. So seems you are in good shape.

Notify the cardiologist should the pain/pressure worsen or become more frequent.

[Jojasp in reply to mav7]

Thanks for the reply Mav. Yes I agree that it is good news about the echo, but wonder why he has requested the CT cardio-aniogram ? On the day of the echo, my chest pain was so bad I wanted to go to A&E, but as I didn’t want to miss to the echo appointment I thought I would go to the scan and then go after. However by the time I had go to the hospital for the echo and they had done it - about 3hrs - the pain had subdsided to what just felt like mild indigestion. Although I have been a little anxious about this, I don’t usually suffer from health anxiety, but wonder if it is something else ? Thanks for you reply and hoping all is well with you

[mav7 in reply to Jojasp]

wonder why he has requested the CT cardio-aniogram

mayoclinic.org/tests-proced...

Missed your note about the CT cardio in the original post. See above link. Checks for narrowed or blocked arteries and blood flow to the heart.

Relax ! Seems you have an excellent cardiologist who is very thorough.

[Jojasp in reply to mav7]

Thanks for the reply Nav - good practical advice - thank you

[Ppiman]

I don't think everyone gets chest pain, but I do. I would call it discomfort rather than pain, but it seems to be gastric and radiates into my back, too. It is normal for some people, I was told, and isn't anything to worry about, all else being equal. The findings from your scans all seem pretty normal depending on your age.

I suspect the cause of the discomfort to be related to the reduced blood flow that happens when the heart isn't beating at its best. I take a 1.25mg tablet of bisoprolol when it happens which helps after about an hour or two and lasts for well over a day. I can get issues at any heart rate, but mine is more often mildly racing at 85bpm - 130bpm when it happens, although, like you, in the late 40s too.

I don't get much AF these days, mostly runs of ectopic beats, but these cause just the same discomfort and sensations.

It's hard not to worry so you have my sympathies, but as your scans show nothing of much consequence, you can surely rest easy. Anxiety with this condition is a bugbear!

Steve

[Jojasp in reply to Ppiman]

Hi Steve, thanks for your reply and sharing your story and views. I think once I get the results from the CT cardio angiogram and if they are OK I should be able to relax more. Really helpful to know that you have had chest pain and afib too, as was worrying particularly about the former as thought they could be two separate things. Hope all is well with you and thank you !

[Ppiman in reply to Jojasp]

Yes, thank you, Jo - all well. The link below might reassure you further but I know how you must be feeling waiting for results:

nhs.uk/conditions/atrial-fi...

Steve

[secondtry]

Hi Jo, I think low pulse is likely a contributory factor triggering AF. I found my vagally mediated PAF was most likely to start when I relaxed (and pulse fell ) in the evenings or during the night. Many years later after stopping AF with Flecainide and lifestyle changes, I have found I am most comfortable when I keep active and therefore pulse around 60, normally 45-55.

[Jojasp in reply to secondtry]

Hi second try,

Thanks for your reply. I have only had two episodes of known Afib and I was resting at the time. My chest pain has also been worse early in the morning - it seems to wake me up from sleep. Exertion or exercise doesn’t seem to make it worse … in fact as the day progresses it seems to reduce to what feels like mild indigestion. Thanks for sharing your experience it is definitely something for me to investigate further. All the best, Jo

[BlueINR]

I have had at least 15 afib episodes in the past two-and-a-half years, and none of them had pain. Any type of chest pain needs to be seen ASAP. In the US we would call 911 for paramedics or have someone drive me to nearest Emergency Room. I would imagine you have something similar. Chest pain should not be ignored. It may or may not have anything to do with the afib. Please get yourself seen ASAP.