Bisoprolol - to take or not to take - that is the question ... ??

[HenningLob]

Comments pls on reducing dose or abandoning taking Bisoprolol ...

Following aortic repair and aortic valve replacement open heart surgery over two months ago my husband has just had post op review meeting with his surgeon. Despite continuing problems with finding the thudding mechanical valve hard to tolerate hubby is physically in good health and surgeon said it was up to him whether he continued with Bisoprolol 3.75mg per day or lessened the dose or abandoned taking it altogether. Am interested to hear of other people's experiences following coming off Bisoprolol or lessening Bisoprolol dose following open heart surgery. Thank you!

[jimmyq]

Wow! That's a biggy! He should discuss it with his doctor.

[HenningLob in reply to jimmyq]

Yes does feel like a biggy though the surgeon who did op was the one who suggested it!

[stevejb1810]

I agree with Jimmy on this one - you should seek medical advice and probably from a cardiologist. If he does stop taking the drug he can expect his resting pulse to go up a little (maybe 10 or 20 beats per minute) and his blood pressure to go up a bit.

[HenningLob in reply to stevejb1810]

Thanks for the info!

[Cliff_G]

Hi, HenningLob

Beta blockers such as bisoprolol are standard after an aortic repair, or even pre-repair with an aneurysm. The essential issues are a. to keep Blood Pressure under rigorous control (120/80) and b. after an AD to keep the heart rate below 60 bpm (these are recommendations from a Guideline document which I can quote if needed.) There is also an opinion that beta blockers can be protective against further aortic deterioration (also ACE/ARBs) though there is evidence both for this and to say they make no difference.

A cardiothoracic surgeon saying that bisporolol is not needed any more is a new one on me and outside my experience. I am on 2.5 mg of bisoprolol and understood it was basically for life.

My valve also clicks away but I have got used to it. If sleeping is a problem try a white noise app. I use one, selecting the "stream" sound and find it really helps to not lie there listening to my valve!

As always, everyone's case can be subtly different, so I would say that a discussion with his GP is called for and if needed he can write to the surgeon to get further clarification.

Hope this helps

[HenningLob in reply to Cliff_G]

Thank you Cliff_G. Yes I do agree that further discussion with GP regarding reducing bisoprolol would be prudent. A reduction from 3.75 to 2.5 could be a possibility.

It's very encouraging to hear that you have got used to the clicking. Can I ask you how long it took for you to get used to it? Also did the clicking change at all? Initially my husband heard it more as a click but in the last few weeks it has developed into intense thumping and pounding and it is the sensation of it that is very problematical. Very fortunately he is able to sleep but it is during the day that he is so troubled. We are both wondering whether in fact being so conscious of it could actually make it worse. Thanks for the white noise app idea. Will definitely give that a go during the day. Thanks for all your help!

[Cliff_G]

I think I initially got used to it pretty quickly as it was the least of my rather serious troubles after an emergency operation. I then had a bit of a period from about 3 months where I was much more aware of it but realised that as I knew it was with me for life I had to accept it, for all its nuisance (including warfarin of course). For me it was more the noise at night and the way it announced my heart rate changes, which were a bit worrying (used to those also, now). It does have periods now and then when it thumps. Some of that is postural, it's much worse if my chest is sort of closed in, and better if I stand/sit with the rib cage nice and open. But overall (17 months now) it's become a friend. As for your husband, it's only two months and early days. He will get used to it.

There are some other forums around you could ask in, with many more folk with similar issues, some specifically for metal valves, and for aortic aneurysms/dissections/repairs. The one I use a lot is the Facebook private group "Aortic Dissection UK Buddies".

Best wishes to you both

[HenningLob in reply to Cliff_G]

Belated but still want to say thank you so much Cliff_G for taking the time to reply. It's great to have practical advice like the tips on posture and also the thumper being your friend! It's interesting that the more you explore many people really do seem to experience that the whole recovery and getting back to normal process does take longer than a couple of months. As for the annoying pounding of the valve, it's very supportive to read your affirmative "He will get used to it". It feels very believable!