I just wanted to ask if anyone else has been experiencing more breathlessness with the weather change. My mum has Permanent AF with heart failure. She’s had bisoprolol increased in February this year from 3.75mg once a day to the same dose twice a day. We had a GP appointment last week which I asked if they could do an ECG. The doctor said mums heart rate was going up to around 92 while he was checking her. He said continue with the 2 doses of bisoprolol for now. It’s just odd that she’s feeling more and more breathless and as it’s getting warmer, the heat seems to be triggering it more. Mums never had asthma yet for past 2 years, she’s been given an inhaler to use as and when required. At the moment, even the slightest walking is making her feel short of breath. I feel helpless as I don’t know what else I can do so that she doesn’t feel out of breath and tired all the time. Has anyone else experienced this and what do you do to help with the symptoms please?
Breathlessness- pollen or something e... - Atrial Fibrillati...
Breathlessness- pollen or something else?
Sorry about your mum. Weather and humidity can sometimes play a role, but if the breathlessness coincided with the increase in bisoprolol, you might ask your doctors about a medication change or adjustment. What has your doctor said about it?
Jim
Mums been on bisoprolol for over 3 years now, they started her on 2.5mg, was increased last year to 3.75mg, and then to 2 doses. When I’ve questioned GP about breathlessness and bisoprolol, he said it’s a good tablet for mum as she has AF and heart failure, he also mentioned that some other beta blockers have more of an effect on breathing than bisoprolol. I’m so confused. They seem reluctant to change medication, and mums already on a lot of medication so I’m concerned that another change could cause side effects.
Heart failure can cause congestion in the lungs and hot weather puts more strain on the heart. I can’t remember if your mum tried taking diltiazem instead but doctors do tend to favour bisoprolol for heart failure. I would definitely query the medication. Has pace and ablate been suggested?
Your mum is lucky to have you but I know what a strain it is supporting a loved one when you feel helpless 💞
Hi,
No, mum hasn’t tried diltiazem, I keep getting told that bisoprolol is one of the better medications. No one has ever suggested a pacemaker or ablate either. Possibly due to mum having other health issues too.
Thank you, it’s definitely stressful feeling constantly worried as a carer. xx
yes I’m feeling more out of breath. They’ve doubled my dose to just 2.5 mg and I’m also very tired
Hi Nickybhf,
I have a AF diagnosis but mine is highly controlled ( for now at least ). I am sensitive to allergy stuff. I live on the border of an village and farming land. I also drive buses around rural Cornwall and so am constantly bombarded with pollen, even occasional rainfall doesn't settle it.
This year has been the worst ever and this breathlessness is wearing me down. I use a nasal spray which usually is good ( and works well with my Warfarin and other drugs ) but is now about as much use as a chocolate fireguard.
I plan to contact my Surgery Pharmacist to see if she can organise an inhalant ( like a Ventolin thingy ). The nasal spray sorts the nasal passages, but isn't sorting my cough, cloggy chest and breathlessness.
My sympthathies to you and your mother.
John
Hi John,
Thank you for your reply. Mum has also been given the nasal spray which helps with the blocked nose, but not with the breathlessness. Mum has been given the blue inhaler which helps somewhat, but shortly after she’s breathless again.
We can definitely relate and say the pollen is really bad this year. I hope you also get some help with the breathlessness.
Was Mum shown how to use the blue inhaler properly? It's surprisingly common just how many don't. Was she given a spacer, big plastic bubble thing that you spray into one end and have the other in your mouth? This makes it much easier to take in the full dose and get the most benefit. A downside to Ventolin is that because it's a steroid it increases the heart rate so someone with AF might struggle when using it because of the increase.
Hi, I have mild asthma, and at the time of my AF diagnosis I was taking a variety of things for it , including Ventolin. The Cardiologist who treated me stopped them all except Symbicort, as he said Salbutamol,( Ventolin and its many generics in particular,) is bad for the heart. Symbicort is a maintenance inhaler not a rescue like Ventolin, but you can take extra puffs if you need them.
Same here, breathless, horrible hrrible post nasal drip; nose not blocked at all but coughing until my ribs hurt for 5 weeks solid. Been given steroid nasal spray, antihistamine eye drops that drain into your nose, breathe easy spray, antihistamine tablets ; a stronger antihistamine that knocked me out and still coughing myself to bits every morning. Propped up in bed and still waking after 3 hours rattling and coughing. Nothing is helping. I've never had hay fever if that's what it is although I've had suggestions it could be the "100 day cough" that's going round but I believe that's whooping cough which is not w hat I have. Sore throat and tongue from sleeping with mouth open. I don't have heart failure though
Could it be fluid overload, do her ankles/legs swell? I think maybe another echo to see how the heart is doing, maybe drugs need to be increased or changed to another. I am in the same position as your Mum, H/F etc., and had a really bad nights sleep, had to raise the head of my bed etc., and I think it was due to the heat in my case, I just couldn't breathe, however I shall be monitoring it over the next day or two.
Hi ,
Mum does have some fluid as one of her legs is more swollen than the other, but she’s on 40mg of fureosemide. I hope she doesn’t need to increase that as then it’s worrying that in this heat, there’s a chance of getting dehydrated.
Nicky, I believe 40mg is rather a heavy dose and don't think they would want to increase that. I am taking 20mg Fureosemide, 10mg Bisoporal and 2 x 150mg Propefenone plus anti coagulant. It might be worth asking to see her cardio specialist as its not really with in the scope of a GP and get her reassessed for meds etc., in the meantime for hydration and fluid retention I find water melon and other melons good as they are natural dietetics and I am sure there are others and raise the head of her bed, I find this helps as well as keeping feet up during the day to help heart/circulation plus no over exertion, Good luck x
Thank you, will get some watermelon. Also, just said to mum today that she will need to sit with her leg raised, hope it helps.
I hope this helps and yes, she should always sit with legs up and even a cushion under too, if she has an electric bed she should be able to raise her legs up in bed or again, a pillow under the legs, this helps with heart circulate and not have to work too hard ie from the feet upwards. I didnt want an electric bed myself but needed a new bed when we moved home and singles and got a price offer we couldn't refuse and my goodness has it been a God send, especially after I broke my hip and had full replacement then my A/F escalated into heart failure so wouldn't be without it now.
I'd contact her specialist because fluid build up can cause breathlessness and it's not really in the scope of a GP . They are probably inundated with patients with hayfever and that would be the first thing on their minds. I've never ever had anything like this has been yet hayfever was the only thing my GP considered.
Thank you. Our problem is that cardiology have left the GP to monitor mum. Whenever I’ve spoke to GP about mum being seen by cardiologist, the GP has told me that cardiologist has told the doctors to monitor mums condition.
Yes, I agree with Jim — it’s possible the increase in bisoprolol has a bearing. I, also went for walk yesterday and was breathless — I put it down to humidity and general sultry weather. I gradually gave up bisoprolol because it was making me too lethargic and tired.
Thanks for reply. Did you swap to a different beta blocker?
No, I didn’t. I really didn’t want to experiment with other types of beta blockers. I now just take apixiban and flurosomide ( the diuretic) for atrial fib. I’m 75. TBF, those 2 suit my system.
Thanks, I’m just concerned that without the bisoprolol, will mums heart rate go ridiculously high again. Recently it’s been fluctuating to around 100 and then gradually comes down.
I am asthmatic as well as having permanent AF. Beta blockers caused problems, including sudden exacerbation of asthma which led to 3 days in hospital. The only treatment I have because of AF is an anticoagulant.Yes, yesterday in the heat I felt more short of breath than normal. I live in a hilly village and yesterday I needed to walk 100yards uphill and it felt like I was climbing a mountain. I also have foot drop of my right foot, so walk with a stick. Today I will take an antihistamine and try to stay indoors.
Thank you Thomas, did the antihistamine help?
I wonder whether it’s worth me asking for one from the GP.
Yes the antihistamine worked. There are 2 regular over the counter anti-histamines. The cheapest can be bought at Lidl, Aldi and The Range. I find Cetirizine hydrochloride work better for me. Other brands are more expensive but are the same ingredients.
It sounds as if the walking is setting off ectopic beats or AF. This happens to me sometimes and causes a kind of breathlessness, although not pronounced. Do you have a home ECG device at all to check? An Apple Watch is what I use as it's so handy, but it doesn’t seem to like sweaty wrists, I’m finding. The Kardia, Wellue, Emay or Contec devices are all very portable, with the latter three even having their own onboard miniature screens.
Is your mum’s inhaler given for any lung issues such as COPD, perhaps? A friend has this along with HF. The treatments are working well for him, thankfully, and have brought his EF to the high 40s to his surprise and pleasure. He hasn't reported being more breathless of late but pollen is high and sensitivity to that is individual.
Steve
Hi Steve,
We do have a Kardia, it always shows AF which is no surprise as we know mums is permanent. I don’t really understand anything else on the Kardia.
I’m not sure if the inhaler has caused any lung issues, it just seems to help a bit initially when the breathlessness starts. I do think mum has some excess fluid as I can see part of her right leg is more swollen than the left but she’s already on 40mg of furosemide.
She might need a different drug for her oedema, perhaps. Also, these drugs can alter the electrolyte balance badly which can then cause confusion and heart issues so watch out for that. Just this happened to my grandmother and the hospital initially said it was dementia, to which I replied, “What? She developed dementia overnight?!” It was, of course, her water tablet. My elderly friend has permanent AF at a normal-ish heart rate and he is fine except on slopes.
It might also be worth buying what’s called a peak flow meter and taking readings when she’s at her best and worst, breath-wise, also a reading needs to be taken each morning and evening before any blue asthma relief sprays have been used as a large drop overnight can indicate important worsening. In that case (I seem to remember a 20% drop was the important difference - but her GP will know), she might need more aggressive treatment (often extra brown inhaler doses or steroid tablets). Asthma is often under treated and its worsening can be missed.
Steve
I have asthma and can't use beta-blockers. I have dilitiazem instead, so if it's the medication, perhaps a change might do the trick? Hope your mum feels better soon x
I’m glad that diltiazem has helped you. I don’t think the doctors seem keen on changing mums bisoprol. I keep getting told that bisoprolol is one of the better ones.
What effect do BBs have on you? I am mildly asthmatic and take 1.25mg Bisoprolol per day. Because I have frequently seen on this site that BBs are contraindicated for asthma sufferers, I have asked 3 Cardiologists if I should be taking it, They have all said the same thing, that Biso is Cardio specific and will not affect my asthma. Certainly, from my AF point of view, it is great , it keeps my HR in a steady mid 60s .
The first time I ended up in hospital with AF I was told I should never take BB's as they can leave you breathless. I've been on Dilitiazem ever since. This keeps my heart rate down too.
That’s why I’m concerned about lowering the dose or stopping it as mums heart rate has been fluctuating now even on the higher dose of bisoprolol.
Hi Nicky. Last year when I was in persistent AF (prior to ablation) I found humidity had a profound effect on how breathless I became. And that was without any sign of heart failure and no asthma. I was not on bisoprolol but found digoxin very helpful because it strengthened the heartbeat without lowering blood pressure.
Hi,
Thank you. So humidity did have an effect, this is what we’re trying to work out, whether it’s due to weather or something else. It’s really difficult. I’m glad the digoxin helped you.
I find humidity a problem for making my asthma worse. Bisoprolol is notorious for causing fatigue and breathlessness . Your mum is on a high dose. I would dispute the "this is a good tablet for you". If it makes her feel ill it's not and alternatives should be explored.
I have questioned it several times, once we were advised that mum could just stop the bisoprolol for a bit but we are quite scared to do this as mums heart rate was so high prior to taking this medication.
Bisoprolol should not be just stopped. Some people can tolerate this but many cannot and have to wean off - slowly. It could be very uncomfortable for your mother to stop such a high dose abruptly.
Thank you. I think we may have to possibly see a cardiologist privately again as we seem to be getting no where with GP.
l would think, with your mum, that it is a combination of things. This heat we are having is a very humid heat, with a high pollen count. I am also experiencing more breathlessness, since the weather has become hot. Bisoprolol is notoriously known for causing laboured breathing. A cooling fan might help. Also, perhaps a different inhaler might be needed. My daughter had two different ones last year. It is an awful feeling to be breathless, so l hope your mum will eventually get some relief. I would go back to GP.
Thank you, that’s a good idea to maybe ask for a different inhaler, particularly whilst we have this warm weather. I will try and mention this to GP.
My daughter had two at the same time, so might be worth a try. Xxx
I use a combined inhaler which helps with allergies as well as opening up the airways. All you can do really is keep banging on about the breathlessness and hope the docs reconsider.
I was diagnosed with H/F and AF in 2014. Medication was biso 5mg Digoxin, Ramipril and Rivroxaban oh and Fluroseimide 40mg. Had to stop Digoxin after 9 months, gave me memory problems. In 2015 was in hospital with suspected chest infection, it was fluid on lungs because of H/F. Cardiac Dr wanted to up my dose of Biso t 7.5 because I would not take the Digoxin, this had already been tried and I could not tolerate this dose, terrible breathing problems and brain fog. After complaining there must be something else I was given Diltiazem 180mg and still had to take the 5mg of Biso. If you have H/F they have to be careful with Diltiazem because it can cause fluid retention which you do not want. The brand that I was given is Viazem and it did not cause fluid retention.
A few years later in hospital for virus infection, I had very bad breathing problems I was told that I had late onset asthma and mild COPD. So a Ventalin inhaler was added to my medications. From reading on forum that Nebivolol was better for people with chest problems I (it is recommened by medical proffession) I asked to change to this. That was a uphill battle on 3 of my routine visits to cardiac department they said no, on one visit he after looking up his book of drugs prescribed Cardivolol which has a a clear warning on the back of the packet not to be given to people with asthma or lung problems. In the end I pestered my GP and she prescribed it. What a difference breathing improved greatly and I also felt much more with it and alert than on Biso. I have been on Nebivolol for about 5 years now and would never go back to Biso.
At the moment I too cannot tolerate the hot weather or dry air conditions, once the heating comes on in the winter it starts again congestion coughing ect. Have tried lots of solutions in the house but to no avail. I get congestion in my nasal areas which goes down to my chest. At the moment I am sneezing a lot feel as if I have a bad head cold. I have two inhalers, one is what they call a maintenace inhaler (at the moment on Trimbow, but have been trying different ones over the last 3 months, there are so manny on the market it is hard to get the right one for you) used once every day and a as you need it inhaler Salamol to be used when breathing gets really bad. I do have a little bit of fluid retention on my legs and take Fluroseimide when needed, but it does not make much difference to fluid on my legs so I do not use it daily. Tell your DR about Nebivolol and be very persistant. A few years ago Nebivolol was not prescribed because it was more expensive than Biso. It annoys me that many medical people go by what their text books say, wish they would try some of these medications and get the side effects. I hope you get your mum's problems sorted soon it can be a battle unfortunately.
Just a silly aside - I want to the vet a few weeks ago with my dog. He has cushions disease, is on daily medication has been for 2 years and have to watch that he does not drink to much water or pee alot. He aslo has a heart murmor and in the last month has developed a cough, sounds like whooping cough so this is why I went to vet. He now has AF and maybe some fluid on his lungs although he could not detect much congestion there. He said he would put him on Fluroseimide, I looked at vet and said I did not think that was a good idea and said no. I asked him had he ever taken it, you have to be near a loo for hours after you take it. Poor dog would not know what had happened to him, unless back door was left open all day we would have loads of accidents in the house. He would probably be mentally affected lol He has put him on some heart medication so we will see. He is 13 years old so getting on now but I wish was as active and spritely as he is, wish I could run up and down the stairs with no effort or get breathless or run after a ball in the garden as he does.
Sorry for long post. Cassie
Hi Cassie,
Thank you for your reply. I will mention the Nebivolol to GP as it sounds like it’s definitely helped you. Is it okay if I message you as I had some more questions about HF together with AF. I think you can relate so much with what’s going on with mum. I hope your dog also feels better with the heart medication xx
Seasonal pollen most definitely affects my breathing. Two years ago, I had a particularly bad attack in summer and my GP prescribed an allergy shot and an inhaler, both containing steroids. Not knowing steroids affect a-fib, it put me in one of the worst a-fib episodes of my life and I was ambulanced to the ER. Since then, I note when tree or grass pollen is prevalent and take a non-steroid nasal spray called Azelastine which works wonders. Heat and humidity can also affect some a-fibbers with their breathing problems. I certainly hope you can find a solution for your mum.
Thank you, I hope we get some solution too. It’s so difficult getting the initial help.
Hi
BB Metroprolol made me breathless.
BB Bisoprolol even up to 10mg was OK. I take 2.5mg PM.
But BBs did not control my heart rate (pulse).
A private cardiologist physically tested me over 120 at rest.
Introduced CCB Calcium Channel Blocker Diltiazem 120mg AM.
No breathless.
Towards late pm on exertion like going up stairs fatigue.
BBs are not recommended for asthmatics.
The best forward help would be a 24-hr monitor, ECG and even ECHO if she has not had one for 2 years.
The 24hr monitor is best as it shows over 24 hours.
Does Exertion make it worse?
On Metroprolol I had heart rate avg day (couldn't exert) 186 with pauses at night.
On Bisoprolol h/rate avg 156 with no pauses.
Do hope this helps.
cheri JOY. 75. (NZ)
Hi Joy,
Thank you. Mum had the 7 day monitor in February this year, the results showed her heart rate was going up to 160 , we went private and the cardiologist advised us to double the furosemide from 20mg to 40mg, and double the dose of bisoprolol from 3.75mg once a day to twice a day. Gradually, since doing this, the breathlessness has got more frequent.
Hi
Of course because as I said CCB Diltiazem was introduced. Brought down 156 on 10mg Bisoprolol to 51 on 180mg. Too high so reduced
Diltiazem 120mg AM for control Heart Rate
Bisoprolol 2.5mg PM for BP.
I have been on this regime with PRADAXA 110mg x twice for 2.1/2 years.
Any heart rate over 100 would cause breathless.
I take no diuretic.
Although Diltiazem can cause fluid it doesn't with me. Frusemide is terrible. Feet up at night solves any fluid in feet. Heat and not moving itself can cause fluid gathering.
When travelling in South America truck not on airconditioning I had feet and wrists with fluid.
I would not take frusemide unless absolutely a must. 40mg if 20mg doesn't work means it's not that. This med drains all minerals from the body -e.g sodium, nitrates, magnesium, potassium etc.
What is her B12 level. A special blood test. It should be at least 700 level. I, like so many in older age group cannot breakdown to absorb the B12, in dairy, meats, some vegs green.
Why doesn't the cardiologist try a CCB. My h/rate is now Day 60s. My h/rate stays at 47avg bpm.
cheri JOY.
Thanks Joy. So you have both the diltiazem & bisoprolol but a low dose?
That’s brilliant if it’s keeping your heart rate at that level. I’m currently trying to book a private consultation with a cardiologist as we keep getting told that cardiology have wrote to GP and told them to monitor mum. It would be great if mum could come off the fureosemide. She’s already got mobility issues so constantly having to visit bathroom isn’t ideal.
Hi
Yes, Frusemide is awful to say the least.
I got a private consult within 2.1/2 weeks and he up so only had to drive 40mins from here Coopers Beach on the East Coast in Doubtless Bay area.
I got terrible allergy to a eucalyptus tree. It was when the tree was mature that flowers full of oil dumped on my place and damaged paint work. I was tested yes allergy, and given BREO an inhaler. I issued a complaint to neighbour that next time repaint would cost them. They had it removed.
I am also allergic to leather stain.
cheri JOY
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