Feeling tired and depressed - British Heart Fou...

British Heart Foundation
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Feeling tired and depressed


Hello everyone. I was diagnosed with heart failure in July this year. It was a huge shock to me and I had a bit of a nervous breakdown. Despite this I went to all of the cardio rehab classes and continue to try and go to the gym but i feel so tired. I sleep from about 10 at night until 10 in the morning and have to force myself out of bed. My EF in October was classed as between 40% to 45% category and LVSD. I live alone and get really down. I wondered if the bisoprolol 10mg and ramipril 10mg could be making me feel so tired?. The cardio nurses tell me to go to the gym 5 to 6 days a week for 30 minutes if I can. I wondered if anyone was on entresto and felt better with this medicine. They told me it wouldnt help me with my classification of heart failure?

22 Replies

Hello genteel - I am sure you will get some replies on hear from people who have greater knowledge than I do on heart failure but as a first response cardiomyopathy.org have some info on the NICE guideline for prescribing entresto. NICE approve entresto where the LV ejection fraction is less than 35% so I am wondering if that's the reason you have been told it's not suitable for you. It would have been helpful if your Drs explained why it is not suitable then at least you may understand even if you don't agree. You could discuss this by phoning one of the BHF Specialist Nurses. Your feeling of exhaustion could well be to do with the bisoprolol. I was taking 5mg bisoprolol for 6 months and I never got used to it and constantly felt tired. I changed to another beta blocker called Nebivolol and feel great on it with much more energy. I see that Nebivolol is also approved in heart failure although bisoprolol appears to be the first choice. You could ask your GP / cardiologist if they would consider changing your beta blocker to see if it is contributing towards your tiredness. It can't be easy living on your own doing everything yourself so you are doing great with your gym sessions. All the best.

genteel in reply to Nathan53

Thank you for the information Nathan. I am sure somewhere in all of the past consultations they mentioned NICE guidelines and entresto but I forgot all the figures on EF etc. I remember bisoprolol being the first choice though but maybe my depression isnt helping aswell and the loneliness.

Hi. My husband has heart failure, he's EF is currently 30. There is a closed Facebook group could pumping marvellous which is for people with heart failure, their families & carers. & is a great source for support, advice & information. Pumping marvellous is recommended by many cardiologists & HF nurses. I hope you find the answers you're looking for

genteel in reply to Lezzers

Thank you so much for the info lezzers

Hi Genteel. I was diagnosed with HF 2 yrs ago with an output of 17%. The first 18 months I was completely exhausted all the time but had an improvement this year and my output is up to 43%. Still get days when I’m v tired but am so much better by comparison. I’m on Bisoprol as well and did have problems with fainting (or feeling as if I was going to) in the hot weather but most of the time I am fine. Speak to your GP and see what they say. I have a BHF funded HF nurse to ask and have found her a great help.

I have to say there was no way I could have gone to a gym in the early days but have started this year. I won’t pretend I enjoy it but I do get a sense of achievement and definitely feel better for it. I also have 2 dogs who need to be walked every day so that forces me out!

Keep us posted and remember you are not alone in this.


Thank you so much for your reply Fiona. It is good to know i am not alone in this. It must have been hard for you especially the first 18months.

I find my heart condition not my meds make me tired. My tiredness levels vary depending on how my heart condition is or my recovery from a heart surgery. I’ve had tons.

genteel in reply to gal4God

Thanks for reply gal. I think my anxiety and depression about it all has a definite effect on me too..

gal4God in reply to genteel

I get depressed cos of my heart condition. I fact I grew up wiv it doesn’t change anything. The tiredness is often my 1st symptom so I get scared.

Hello Genteel, I too have HF, diagnosed just over 2 years ago. My experience of starting on all the medication is that it took a little longer than 3 months to get accustomed to them all and I found I needed more sleep than usual (and extra naps during the day!). But I feel a lot better now and have a better idea of what I can achieve and how I'll feel if I do too much. I wonder if entresto is offered to those who don't respond to bisoprolol, it's interesting to hear about different treatments. I hope that you start to feel more 'normal' again soon, in my experience the meds and the gym certainly helped!

genteel in reply to Pommel

Hi Pommel thank you for your comments and information. I was told by the cardio nurse today that bisoprolol was the gold standard for heart failure along with the ramipril with my condition. I wasn't offered an alternative. I will have to stick with it for a while longer and hopefully things will improve and sttle down.

Pommel in reply to genteel

I hope you do! I'm on bisoprolol, candesartan (because ramipril gave me a cough) and eplerenone. All standard stuff! I take some vitamin D too.

genteel in reply to Pommel

Thank you! The other two tablets I take are a statin and aspirin 75mg.

Hi there, My husband has tried two beta blockers, both made him feel awful, and he is not taking them at the moment, although he has been advised he should, and is quite active and feels quite good most of the time. Had a CRT-D fitted a couple of weeks ago. Hope you feel better soon.

genteel in reply to purplerain58

Thank you purple rain and thanks for the info. Its a shame the beta blockers make your husband feel unwell, did you see the post about Nebivolol. Has he tried that one? I hope all goes well with the CRT-D and you both are coping o.k

Yes was put on that one and told to take it at night, first of all thought all ok then started to feel terrible again, so stopped them.

Hello! I was really touched by your message. It echos how I feel but I'm not alone. I'm caring for my husband who has less than 20% ejection from his heart so is very poorly but at least he is sat in a chair and awake some of the time. I can't imagine what it's like to be alone for hours. You are in my thoughts.

genteel in reply to Love100cats

Thank you so much for lovely message. I hope there is an improvement for your husband and you soon. Take care.

Hi Genteel. I have heart failure and also sleep much more than I'd like. I'm often in bed by 8pm and sleep through until 7 or 8 the following morning, then feel I could go back to bed around 10am! Not a great look for someone in their thirties, ha! I think it's a combination of my heart and the medication. I am on Entresto and it has worked well for me (feel I have a little more energy than I did on the ace inhibitors it replaced - my heart is not improving, but has been stable for a long while) but my EF is a good bit lower than yours. I imagine that's why you're not being put on it, as some others have said.

I struggle to fit in as much exercise as I should/would like to, but I am managing to go to the gym twice a week at the moment and on those days I struggle to stay awake long enough to eat dinner, so that's probably having an impact on your tiredness too. I figure short-term exhaustion is worth it, in the hope it gives me more energy in the long-term, but it's hard to fit exercise in with everything else you need to do when it wipes you out so much. And low mood (as most of us with heart failure will have experienced) also zaps energy. So no easy solution, but hopefully it helps you to know you're not alone in experiencing these symptoms. Feel free to message me if you ever want to chat. Lots of love x

Thank you for your reply Laura.

I have had a bad cold on top of everything for almost 3 weeks which doesnt help as you cant get to the gym.

I hope you pick up and feel a lot better yourself very soon. You sound like a lovely person.X

laura_dropstitchHeart Star in reply to genteel

I can't cope with colds at all nowadays. No wonder you are finding things difficult just now. Get plenty of rest and do everything you can to look after yourself. You can worry about the gym when the cold is gone. Take care x

Thank you for your reply Laura. Look after yourself too at this time of year regarding colds and flu. Make sure you get any recommended flu jabs etc.

You are right about the gym i will focus on getting rid of cold symptoms first. x

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