shortness of breath in the mornings

[ChrissieMT]

I have paroxysmal AF, recently more frequent episodes. I have also recently had shortness of breath in the morning, along with a slight nausea, would this be associated with AF or could there be other underlying conditions. I am awaiting my 6 monthly check up with my cardiologist, goodness knows when this will be as it was due in June, my GP practice is very difficult to get appointments with so advice is not freely available.

[Desanthony]

It could be AF related, your other underlying conditions, and could by caused by any of your medications for your conditions. Bisoprolol caused me to be very breathless. It all depends on what other conditions you have and what medication you are on. Is this a new thing or has this been happening for some time?

[ChrissieMT in reply to Desanthony]

I have been taking Bisoprolol for a a few years now so didn’t think it was that, the dosage had been upped so who knows? This has been happening for a couple of months.

[Mrsvemb in reply to ChrissieMT]

You say you have increased your dose of Bisoprolol. My money is on that being the cause. It is quite common. I was on Bisoprolol for some years, then started to get breathless and feel unwell.

I have just been through the same with Nebivolol. Fine for 3 years and now making me very breathless on exertion.

[Desanthony in reply to ChrissieMT]

If it is anything it is likely to be the increased Bisoprolol. Hopefully it won't be long before you see your specialist. I would be fine on a beta blocker or calcium channel blocker and other rhythm/rate control medications they tried me on for about 3 to 5 weeks and then the breathlessness and fatigue would hit me again so in the end took nothing just an anticoagulant as the medications were making me feel far worse than AF. Hope you can sort this out.

[SamAdmin Administrator Arrhythmia Alliance AF Association]

Good afternoon

Thank you for your post on the Atrial Fibrillation support forum.

We have a booklet that you might find helpful about paroxysmal AF called 'Atrial Fibrillation and you' please follow the link below.

api.heartrhythmalliance.org...

If you would like to contact the Patient Service team, please contact us on the form below:

heartrhythmalliance.org/afa...

Kind regards

SamAdmin

Booklet

[Ppiman]

I would bet, myself, that this will clear up of its own accord and become one of those things. So many symptoms can be like that in my experience. The nausea you mention could point to an otherwise symptomless reflux acidity problem, perhaps caused by a small hiatus hernia having moved or worsened. These are common as we get older. Taking a short course of a PPI drug like omeprazole is a good way to test if acidity is a cause. This is available from a pharmacy, whose advice I would seek if your GP really won;t see you, as they most certainly should.

As others have suggested, also, this seems as if it might be caused by the increase in bisoprolol dosage. Your GP might be flexible with this drug dosing, as mine is, and get you to reduce it again. I increased a while back to 2.5mg but again take 1.25mg at present each morning as my heart rate occasionally dropped too far from the higher dose resulting in some light-headed feelings. It seems a generally safe drug regarding varying dosage to suit, but that is a doctor's decision every time, of course.

Have you noticed any other symptoms that might point to different causes, such as swollen ankles? Or do you also have asthma or any form of breathing difficulty? Your GP is the next port of call for anything, really and if they really will not give an appointment, a call to 111 or visit to A&E.

Steve

[Vonnegut]

I’m impressed you are supposed to see a cardiologist regularly! It’s fairly impossible to get an appointment with a GP where we live too and then it is usually a phone call from someone you’ve never met! Soon after first being diagnosed when the lowest dose of Bisoprolol was too much for me to take daily, I saw an EP privately who having introduced me to having a smart phone and a Kardia, sent a prescription for Flecainide to my surgery for me after I’d sent him a reading of my heart in AF. I haven’t had an episode now for ages since taking Flecainide regularly rather than as a “pip” and recently I’ve reduced the first one of the day to 50mg, keeping the evening one at 100mg with no episodes. I had hoped the reduction might help reduce my fatigue but it hasn’t so far! Still here at 80 and fortunately, my husband manages most of the things I can no longer do.

[ChrissieMT in reply to Vonnegut]

I wouldn’t consider one appointment with a cardiologist in 4 years very regular! I was diagnosed with AF in 2019, spent 3 days in hospital. Had 2 more emergency visits to hospital with AF. Just the one outpatient’s appointment with a cardiologist December last year and awaiting a ‘6 month’ follow on appointment as of now and still waiting. I have a smart phone and Kardia device with which I monitor myself when I have episodes which are now pretty frequent. It is the same in our area regarding GP appointments.

[Vonnegut in reply to ChrissieMT]

Gosh! I was diagnosed by the paramedics on the way to the hospital so guess my heart had settled back to normal on the way to the hospital, where even though my heart had gone back to normal, they kept me in the “acute” ward where I spent the worst night ever! I have only seen two different cardiologists once in the five years since I’ve had it so it’s a good thing we found the private EP through the AFA as his prescription of Flecainide has worked wonders and I have been AF free for over a year and a half now and reducing my first dose of the day without ill effects.