Side effects with beta blockers

[Aurora0]

In July I was diagnosed with heart failure following chest pain. It wasn’t a heart attack and I’ve since had a couple more and my GP says it is microvascular angina. I’m struggling with side effects from beta blockers getting gut spasms in the night. I’ve tried bisoprolol, carvedilol and Nebivolo. My GP says this is all there for heart failure has anyone else had this?

[Wellington19]

Ask to try irbesartan instead , but if you come off beta blockers be prepared bad withdrawal symptoms

[west9two in reply to Wellington19]

Like what im currently coming off 😑

[45sue]

Have you seen a cardiologist? If not , ask for a referral to confirm the diagnosis &

discuss the right meds for microvascular angina. I understand that beta blockers may not be right for this type of angina.

[Sunnie2day in reply to 45sue]

Actually, beta blockers do help with microvascular angina (MVA).

Vasospastic angina, however, is worsened by beta blockers.

There is more to it all but that's it in a nutshell regarding beta blockers. Hopefully Milkfairy will be along to make a better explanation of it.

My cardiologist has me on Bisoprolol 1.25mg+300mg aspirin every morning and it is incredible the positive difference those wee white tabs have made for me. He believes I have microvascular angina (MVA) but cannot say it as a definitive diagnosis until the very very long queue for the definitive test (angiogram with acetylcholine provocation) has shortened enough to get me from the back to the front.

The beta blocker (and some lifestyle changes) is working so well for me that I can wait for the definitive test. The cardiologist says he will bump me to the front if my symptoms worsen but I've been going along for close to a year on the current medications with very little trouble.

[Aurora0 in reply to Sunnie2day]

I’m taking 1.25 mg of bisoprolol also. The GP ideally wants me on 10 mg of both ramipril and bisoprolol 🤷‍♀️

[Sunnie2day in reply to Aurora0]

Has your GP said anything about referring you to a cardiologist to confirm MVA definitively and manage your treatment?

[Aurora0 in reply to Sunnie2day]

There’s a 18 week wait to see one 🤷‍♀️

[Sunnie2day in reply to Aurora0]

I empathise - the queue for the definitive diagnostic here in Scotland is, according to my cardiologist, at least 18 MONTHS long and growing longer by the hour. I am fine with the standing 'order' to move me to the very back of the queue every time someone else needs to be on it as my current medication and monitoring regime is working for me so well.

But you have been told you have heart failure (HF) and MVA. You really should get in that queue or even consider going private to get a cardiologist on record as saying he/she believes you have HF and MVA. HF is difficult enough to treat but adding MVA into the mix makes it more important for you to be seen as soon as possible by a cardiologist to ensure correct balancing of your meds and treatment. MVA by itself is a difficult condition to get diagnosed much less correctly treated and it wants specialist training and awareness to get the meds and dosages fine-tuned.

Every patient is different and MVA is complicated. All credit to your GP for even being aware there is such a thing as MVA and to further muddy the waters, there are quite a few cardiologists who lack awareness regarding the condition, but MVA is a condition best diagnosed and initial treatment begun by a cardiologist.

I went private when my multiple heart conditions put me into a major wobble spring 2019 and the NHS queue seemed too long at the time for me to wait. I was in the private consultant's exam room in less than 48hrs rather than 3-12 weeks and that seemed well worth the slightly less than £1000 out of the savings (consultant fee, bloods, ECG resting and stress, echocardiogram) and after the echo my private cardiologist moved me to his NHS list = with no lessening of quality of care.

For the record - I don't have HF, I have other multiple heart conditions (check my profile if you're interested but it's pretty boring, lol!).

Considering you've been told you have HF and MVA, I can't stress enough how important it is for you to be seen by an actual cardiologist.

[Aurora0 in reply to Sunnie2day]

Hi, Just saw cardiologist today have gone privately as you suggested. My ECG is abnormal and heart rate fast. I am going to have another echo arranged and go from there. He has changed ramipril to Losartan as I have that cough.

The treatment I’ve had from NHS has been brilliant but the wait for an MRI or to see a cardiologist is too long.

Watch this space.

[Sunnie2day in reply to Aurora0]

I will be watching, looking forward to your next update!

[Aurora0 in reply to Sunnie2day]

👍

[Aurora0 in reply to Sunnie2day]

Update - late last night woke up with a pain in the centre of my chest pressing like a heavy weight, I used the spray with no effect . I felt nauseous and clammy. I called 111 who sent an ambulance. I was given morphine and paracetamol intravenously which took the edge off. The pain/pressure lasted about 4 hours. I am left with back ache and a bruised feeling in my chest. I had a chest X-ray and bloods which showed nothing abnormal. Cardiac triage and registrar think it’s unlikely cardiac related chest pain . I did have some gaviscon and some pills to rule out gastritis. Fed up.

[Sunnie2day in reply to Aurora0]

It is so frustrating to have these symptoms and be told 'Nope, not cardiac'. I'm not at all expert at this whole MVA thing - Milkfairy is your go-to on it, my MVA symptoms are a little different so I'm not going to even try saying yours are like mine so it was probably the MVA. And I don't have HF so I can't speak to that either.

Have you thought about starting a new discussion about your late night visit to A&E? If you do, be sure to note you've been told by your GP that you have MVA and heart failure. There is a huge wealth of experience here and in a new discussion you stand a good chance of hearing some very useful shared experiences from members who've been there-done that.

[Vivi2711]

Carvidelol is the best beta blocker. Kindly consult your cardiologist for the right dosage

[Aurora0 in reply to Vivi2711]

I had horrible gut spasms with carvidelol even taking anti spasmodics with them. Same with nebivolol.