G'day guys and gals ---- much earlier this year my heart chucked a few wobblies and rather than wait a) to see my GP and b) to get a referral to a Cardio Consultant I self referred and paid for privately my own choice of a Cardiac Consultant. Diagnosis followed with recommendations., a slight change of meds and to get more exercise. The exercise I have found quite challenging leading to much breathlessness. However, that said, for quite some time now I have been short of breath and have it accompanied with cough. The damn tiredness absolutely wipes me out. Anyway saw a Duty GP who set me up for Chest XRays and blood tests which all happened yesterday afternoon. My highly regarded INR Nurse was the one who did my BT's and so we had our usual giggle and a chat. She kindly enlightened me as to what it was all about. Seems lilke they are concerned about the possibility of heart failure.
So my question is ..... if a person has a Paroxysmal AF diagnosis, but the condition itself is highly controlled, chucking a wobbly every 4 or 5 years or so, is there a natural progression to heart failure ? Bear in mind I was 65 at the time of the AF diagnosis which makes me 80 + now.
Just want to get my brain together for a possible new adventure !!
Next part of this conundrum - bear with me as it isn't directly connected to AF ..... over many years now I have been experiencing shoulder pain. The right shoulder was an injury ( falling off a bungalow roof onto a timber deck ). All treated and now no trouble. The left shoulder has degenerative change in two joints and it hasn't yet been properly treated and is constantly giving me varying degrees of pain. Always discomfort and mild grade pain 24/7 and worse at night. Increasingly though pain is very high grade pain which tends to move from left to right, create numbness down right arm and pain in right hand around thumb and first two fingers.
I am a side sleeper so although I go to sleep on my right (good) side I tend to thrash around and end up on my left side thus constantly waking up during the night in massive left shoulder pain. So, my question is can suffering long standing broken sleep and long standing pain be a trigger for any cardiac stuff kickin' off and goin' on.
Any thoughts from you folk would be welcome ... I need to get my brain around this and prepare for a Q and A session with my GP on 6/12/24.
Thank you, 'ave a good day.
John
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BenHall1
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Some innocuous possibilities for the discomfort and numbness in your right arm. I'm not a medical professional but I have problems consistent with cubital tunnel syndrome, which for me, comes and goes
"Carpal tunnel syndrome: This condition occurs when the median nerve in the wrist is compressed, often due to repetitive hand motions. Symptoms include pain, tingling, numbness, or weakness in the hand, thumb, and fingers, and can sometimes travel up the arm. Symptoms can worsen at night and be worse when performing certain activities, like writing or typing."
or
"Cubital tunnel syndrome This condition occurs when the ulnar nerve, which runs from the neck to the hand, is compressed."
Yeah, I had wondered about ‘carpel’ tunnel but in the end put it to one side because it all seemed to be triggered by my sleeping on my left side which in turn triggered some unwelcome activity in my left shoulder joints, described by radiographer as degenerative bone change. My left arm is quite normal. So now am wondering about nerve running from left shoulder to right shoulder. Finally, thinking of asking for some neurological consultation. 😱😱
So my question is ..... if a person has a Paroxysmal AF diagnosis, but the condition itself is highly controlled, chucking a wobbly every 4 or 5 years or so, is there a natural progression to heart failure ? Bear in mind I was 65 at the time of the AF diagnosis which makes me 80 + now.
My understanding is that it’s incredibly difficult to determine if AF is the sole cause of Heart Failure but it seems to be common in later life for AF sufferers. As you will be aware John, binary yes/no answers rarely apply to AF but I also know if there is generally no cardiomyopathy or valve problems etc that if your AF is treated and you continue to increase your exercise (finding something you enjoy doing is key) you may be able to not only halt progression but even improve your heart function.
As to your chest pain - good luck with getting a referral to neurologist, you think cardiology is a long wait! What I might do is self referral to MSK but I think you have been there before? Ask to see a neuro physiotherapist for assessment? I work with a neuro physio and they work with a very different diagnostic methodology because they specialise in nerve function/dysfuction.
Sounds like you have a lot going on John, hope you get somewhere because getting adequate restorative sleep is really important for our heart health.
Thanks for your trouble and comments. Quite a bit there to mull over. My heart kicked off earlier this year and I paid for my own consultation with a Cardio Consultant ( trained at Groote Schur, Cape Town ). It wasn't AF. Kardia readings show me to always be in NSR. Apart from high BP and the AF burden, the only other 'stuff' goin' on is:
1) Peripheral vascular disease
2)Ectopics
3)Calcified coronary arteries with only mild coronary stenosis.
At this stage neither cardiomyopathy or valve problems have been identified. I'd never heard of such a being as a neuro physiotherapist but reading up on it would seem to make it a great idea. Makes alot of sense.
My dealings with the local MSK Interface people wasn't successful down 'ere in Cornwall, but I am attracted to the neuro physiotherapist idea.
You seem to be having a tough time of late. I am not a medic, but if your AF has been controlled it probably isn’t the sole cause of diagnosis and heart failure comes in many degrees. The older we become the more wear and tear on all parts of the body. You have been excercising quite strenuously without getting enough rest and to me it speaks volumes that your heart is complaining. Rest is as important as excercise. Everything in moderation. Looking at your problems l would be looking at slowing down, gentle excercise and relaxing more. Not being rude, but we don’t get any younger. My best wishes to you, take care and let us know how you are.
I do have a tenency to go at things - bit like a bull in a china shop 😱 Even so , I feel that I have no choice but to slow up, not enough breath, too much breathlessness and just ongoing tiredness. All the usual checks seem ok .... BP, HR and Spo2 .... anyway I'll give an update at the end of next week when all results of XRays and bloods will be available. I'm finding the NHS App quite useful.
can you refresh my memory on what ejection fraction is? I get cardio checkups twice a year and I don't think I have any problem with that. I am 86yo and had episodes of AF for 14yrs thanks to a stupid Dr overdosing my thyroid meds. I usually have about 4 episodes a year lasting average 6 hrs. I am on Eliquis and take a metoprolol (beta blocker) when I go into AF to keep heart rate under 100. Just curious as I am so afraid of heart failure I am slim/fit.
I was a side sleeper, could only sleep on left side. So when I got a frozen shoulder my sleep was very disturbed until a physio diagnosed the ‘frozen shoulder’ as a trapped neck nerve, fixed by a simple exercise and a couple of lifestyle tweaks after months of pain. Then had pain down right leg which only a cortisone injection helped but in the process I discovered that I needed to sleep with a pillow between my knees or on my back with a cushion under my knees. When I moved home I treated myself to an adjustable bed as I was also getting pain in my left shoulder, reflux and sometimes breathlessness at night. It took a while to train my brain that I could sleep in a virtual hammock on my back but once I had it was magic! So I’d encourage you to experiment with different sleeping positions (and possibly try a different mattress) to see if that helps. Best wishes
Hiya Buff ........... thanks for your comments. OMG ! you've been through much more than me ........ I think I'll shut up ! Seriously, thinking about your comments a bit more, there seem to be two issues 1) ... a nerve problem which hasn't been properly identified and 2) ... a physical degenerative change in joint bones in left shoulder which have been clearly identified. So I'm beginning to think I need someone to bring the two issues together. Maybe someone clever as CD suggests - a neuro physiotherapist. Anyway we'll see how the coming week unfolds.
John I also sleep on my right side and my left shoulder affected from sport wear and tear has given me issues after golf. I got fed up as it was getting worse and also would wake up sore on left shoulder during the night even though I slept on right side. A new sports physio said he believes it’s frozen shoulder maybe Google that.. apparently it gets better over time. If it’s not in a month we will do and MRI
No sport wear and tear for me ............ just dropped off a roof and speared my right shoulder into some timber decking. Didn't tickle I can tell ya ! Nothing broke, amazingly, BUT ........... the impact shifted my right clavicle slightly up into the neck .... so that both left and right clavicles are out of alignment - meaning shoulder to shoulder is all out of alignment.
The right side shoulder is not a problem since I've had a steroid injection back in 2022, full range of movement - brill. The left shoulder is old age (basically) !😀 affecting BOTH Glenohumeral and A.C joints ... I'm very annoyed because all that happens is I get referred for physio which is making pain worse. I think what CDreamer says about a neuro physio is worth looking at ........... one thing I've discovered is a sports physio is no value at all.
I'm just like Mcgandy says ... go to sleep on my right side and wake up in damn pain in the small hours on my left side. I'd love some body to do an MRI so that I can be sure we're all singing from the same damn hymn sheet AND that we all know EXACTLY WHAT THE ISSUE IS !! Its all guess work at the moment. See my GP on 6 Dec 😱
Only thing I can add to the above is that as someone who is in continuous but well controlled AF with a reduced ejection fraction, I was advised that sleeping on my right side was recommended.Back sleeping risks snoring + sleep apnoea, itself a risk factor for AF triggering, and sleeping on LHS can slightly cramp the ribcage around the heart.
So I do my best to start the night on RHS but always wake up on my left......
I know we're all different but interested to know what dosage of bisoprolol people take to control AF. I'm currently on 2.5mg a day but still getting SVTs which then lead to PAF.. mercifully very short bouts at moment. Am wondering if I should switch to verapamil which cardiologist thinks I should try or do I increase my dosage of bisoprolol which do has suggested. Oh decisions, decisions..
I don't mean to be pedantic, BUT, I was first diagnosed with paroxysmal AF in early January 2010. In addition to the party bag of drugs I was already on, my Cardio Consultant then put me on Bisoprolol 5mg and Warfarin (the dose to be determined from INR blood readings). I was told that Bisoprolol is a heart rate control drug with some properties that assist with blood pressure control. I understand SVT requires a rhythm control drug .................... all that said I gather beta blockers ( like Bisoprolol) can be used.
Rate control and Rhythm control may seem the same but I think you'll find are different requiring different approaches to problem solving, including Ablation procedures.
Based on my 15 years experience I would try 5mg Bisoprolol first if he has recommended it and note any variations in side effects and then discuss it with your consultant or your GP. If you get no benefit then switch to Verapamil as he suggested.
Thank you Ben Hall. That seems sound advice and ties in with medical advice. One other question, do you know when your in AF? I feel every thump and the fast, erratic nature effects it's happening and that I find difficult to manage if I'm out and about.
Back in the beginning I did know when I had lurched into AF. My chest felt like there were a squadron of Butterflies having military style dogfights in my chest. OR - and you need to use your imagination here - like a clear plastic bag full of well composted earth with shedloads of earthworms wriggling away to their hearts content ! Over the years since 2010 I have managed to control my AF, mainly through diet and medication, so nowadays I get an event once every 4 or 5 years which really troubles me. My other problem is I am one of those who are described as asymptomatic - in other words, I can be in AF, not know it, not have any symptoms.
So, if and as and when I do get one nowadays, as happened early in 2024, it was neither worms or butterflies but more a heavy feeling under the left lower ribs. No way do I feel anything fast and/or erratic .... not to say it isn't happening - comes back to this asymptomatic thingy.
Just reread my message and surprised you made sense of it... predictive text!I think I am aware of each and every occurrence. Thus far the longest has been about 20 minutes. Only diagnosed a few months ago so early days tho ectopics have been with me for donkeys years. I have cut out alcohol, caffeine and reduced sugar and carbs. Sadly not made any difference... or maybe it's working to some degree and would be worse if I hadn't!
Thanks for sharing your experience. It's very helpful
Hello!I was diagnosed with heart failure in my mid 40s which was directly due to AF but I'd had AF for nearly 20 years at that point and it was uncontrolled and persistent.
All of which is now reversed due to being in NSR for first time in 20 years.
I also get shoulder problems. I have rheumatoid arthritis but also I'm told shoulder problems are more common in people with heart issues plus those with thyroid issues which I also have.
Definitely for me poor sleep was a trigger for worsening symptoms of AF. Early mornings were a particular problem.
I must say there is much written by your goodself, and Mcgandy and OzJames that really, really resonates. Specifically, taking into account all your 3 comments, and not in any order .... sleep issues, arthritic issues (left shoulder), highly controlled paroxysmal AF with a gradually reducing ejection fraction (but as far as I know nothing to worry about), general wear and tear in both shoulder joints which includes an injury from a fall.
Its really weird but when the pain really kicks off I feel like peeling back my various skin layers and manually seperating the various joints to give them breathing space. Weird ! For the last 32 years I've been a bus driver, so posture problems have accumulated. The older buses I drove were ergonomically rubbish to drive. The modern ones, ergonomically (and many other respects) are a doddle. In fact I'd rather drive a modern bus for 12 hours than I would drive my Nissan Juke for 12 hours. Brilliant car as the Juke is, the ergonomics could be heaps better.
I too have experienced shoulder pain, up around the side of my head & down to my fingers with pins and needles. I've had severe heart palpitations for decades which then lead to 2 episodes of severe, acute blood circulation cutoffs that lasted for 20 min each time. I am convinced that my shoulder pain & pins/needle episodes are related to my long ago whiplash car accident and that it is not related to my heart issues. Metoprolol, peridopril, low dose aspirin & statin meds are now keeping my palpitations to a minimum and hopefully my peripheral, artery spasms won't happen any more. (I get physiotherapy 4 sessions per year to control my neck pain.) Good luck with your treatments.
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