After my HA in March 2020, I felt I was recovering well - feeling well and exercising regularly. I experienced some ectopic beats in the summer, which were checked via 72 hour monitor and deemed to be harmless - they faded away after a few weeks. Other than that life has been pretty much back to normal in terms of day to day activities.
Medication wise I was on:
Morning
10mg Omeprazole
75mg Aspirin
2.5mg Bisoprolol
25mg Losartan (changed from 10mg Ramipril due to reaction shortly after leaving hospital)
90mg Ticagrelor
Evening
90mg Ticagrelor
2.5mg Bisoprolol
80mg Atorvastatin
Due to Covid all follow up was via telephone with the cardiac rehab team, and I had a few appointments with my GP to check blood pressure, cholesterol level and organ function given the meds - all fine.
Around the start of November I was contacted by Cardio Pharmacist with whom I had not spoken since leaving hospital. Initially the desire was to increase my Losartan dose from 25mg to 150mg, I increased gradually to 100mg but was very dizzy and tired, so dropped back to 50mg. My GP was keen to stick to a lower dose given the likelihood of long term use (I’m 43).
At the same time my Bisoprolol was “optimised” to 5mg in the morning, then reduced to 3.75mg again taken once a day in the morning.
Since the change of meds I have felt progressively worse. Initially there was a significant increase in periods of ectopic beats, which are still ongoing although have not been as bad this week. But leading up to Christmas they were daily for long periods and I felt like there was just nothing in the tank, no leg strength at all. I am able to walk and exercise without chest pain and without being out of breath, but my legs feel like lead and I am light headed throughout the day. All of this of course has made me more anxious than normal which doesn’t help, and I’m an active person so the fatigue is really getting me down.
It seems a coincidence that these symptoms have come about at the same time as changes in medication doses/timing but may be completely unrelated??
I have a call with pharmacist on Monday and GP on Tuesday, I am going to ask for a referral to a cardiologist as I have not seen anyone since being discharged. I know my heart was damaged by my heart attack but I would like to know how badly and have the opportunity to have some of my questions answered, if I need to go privately then so be it.
Thanks for “listening”, stay well.
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Might not be applicable to you, but maybe worth mentioning to your GP, I suffered from Vit B9 deficiency due to the Omeprazole which can cause malabsorption. It caused me to feel 'wiped out' as you say nothing in the tank, exercise was a struggle where it had been going really well.
Once on Folic Acid tablets, within a few days I was back to normal, exercising etc.
Worth asking & having it checked, if you haven't already.
Gaz
in reply to
Just to add, if it was me I would also consider telling my GP to put me back on the regime I was on when I was feeling good, that would tell me if it is the change in meds, or not.
My instant thought to your reply was yes yes yes! I am allergic to PPIs and coupled with this I have a low B vitamin absorption rate. This causes my homocysteine level to be high, so I have to take vitamin B supplements to keep it within the normal range. In my case, my high homocysteine is hereditary and it was considered to be a signicant factor in the formation of the blood clot that gave me a HA.
I keep an eye on BP and heart rate during exercise via a chest strap (which I used in the gym prior to HA).
BP dropped as Losartan increased and I did have a trip to hospital a couple if weeks back when palpitations were going on for a long time, and I checked my BP which had shot up. On reflection is was probably worry, which is a tricky one to manage given that the worry stems from health issues.
BP and HR are back at “normal” (or new normal after medication) levels now but other symptoms persist.
Yes, you need to be proactive with regards to medication. There will be a balance between the Bisoprolol and Losartan. I fear that GPs do not fully understand this. In my experience they also have a tendency to over-prescribe. Thankfully my GP practice has a consultant pharmacist to assist with such things and she sorted my prescription, though it took a while.
You sound exactly like I was after my HA . I cold barely get out of the chair, I had hallucinations, I just wanted to sleep. I was existing not living. I didn't expect to feel ok right away but surprisingly I did. It was weeks later when the tablet side effects kicked in. I ended up having most of mine either changed or stopped. Do speak to your GP. For me bisopralol was the culprit for being so exhausted. As my HA was mild I am no only taking simvastatin, furosemide which I was on before the HA, aspiring and famotidine for my stomach
Thank you, I had previously understood that side effects would come about in the initial weeks but with statins it seems like that is not the case. Totally bamboozled, I’m sure the answer lies in the meds but feel there will be a bit of trial and error getting to the answer... hopefully. Like you say, this is existence, not life. Very disappointing having got life back through the summer with gym, walking, hill walking, out with my dogs etc. All of these are a complete chore now.
Don't expect to sort everything all at once. It took almost a year to sort mine out. Different meds suit different people. It may just be dosage that needs tweaking and it can be very difficult to work out what's causing what. Some of them can take a long time to clear from your system. I had to come off the first statin for almost 3 months to be sure it was that that was causing one problem, just to get it completely out of my system before starting another one that suits me much better.
My med was changed from Ramipril 10mg to Losartan 50mg, and since then I have been suffering from severe fatigue, but my cardiologist will not admit that it is the Losartan causing the problem. I have have had blood tests done, and they were all OK. I still maintain that the Losartan is the culprit, so I will have a word with my GP to change it over to some other BP med. Someone else on this site did say that all BP meds make you tired, but they are a necessary evil. Good luck with your problem and I hope you get it sorted out soon.
In my experience Losartan is an excellent medication. I have been on it for 10 years now. The dosage you are on may be too high for you. There are alternative ARBs of course which may suit you better.
BTW, I have never experienced depression on Losartan. I hope you get the issue sorted soon.
Thank you for your reply. Glad you find Losartan suitable, but everyone is different, what suits one person does not necessarily suit another unfortunately.
Indeed we are all different, that's why we need to be proactive in getting our medication tailored to our particular needs. I know too many people that accept what is prescribed and live with the side effects. 😕
I think it sounds as though you have a lot of feed back here to help but like so many others, ypur feelings are probably from the meds, I take it you had a stent fitted? it took me a year post HA ( .ay 2019) to get it all right, lowering the BP meds, stopping them and so on as I had feelings of tiredness and light headed, we finally cut back on the Statin from 80 to 40mg, which seemed to do the trick and stopped the BP pills which was a ramapril and Bisoprolol as I managed to get my BP under control without the pills, but we are all different, I am 53 and very active so I am hoping the my diet and exersise is the reason for that now. But all of the pills can cause fatigue the Statin is a regular one to watch as as said to me 80mg is the highest dose so worth talking a out if your cholesterol is under control. your not alone in all of this so many of us have had similar issues.
Just a quick update, and another lesson for me as the post HA journey continues. I am feeling much better now and in terms of medication have changed.... absolutely nothing.
This last month or two has just demonstrated to me how much of an influence our mental health has on our physical well-being. I would I not have said I was suffering from depression or anxiety, but in reality I probably was to some degree and it was manifesting itself physically.
I made an appointment to see a Cardiologist privately, initially referred to have an echocardiogram to understand the damage to my heart following my HA. Once with the consultant I laid out my fears, concerns, questions and current state of mind... he had all my files and spent an hour taking me through everything that had happened. He concluded I was doing very well, had suffered very slight damage which was inconsequential - he had an echocardiogram on file I had never seen or had explained to me - and should get on with life, take my meds and manage my lifestyle. The whole experience brought me great relief and allowed me to draw a line in some form under what I’ve been through.
So, having not really been pushing my exercise because of Christmas, long dark days and feeling so lethargic I started to pick things up again, consciously and not allowing the lethargy to put me off because, once I’d done the walk or the cycle or the cross trainer session, I felt much better for it. I’m now doing online spin classes three times a week, pushing pretty hard and feeling good with it.
The ectopics, the things that started all the worries about 3 months ago, have gone. No change in meds, no massive change in diet, but certainly a change in mindset having been reassured they are nothing to worry about and not there to be focused on.
I haven’t been on here much because, although massively grateful for the help and advice I’ve had in the last (almost) 12 months, constantly researching and reading was causing me to focus on obsess and worry continually about my health.
The journey will be lifelong I’m sure, there will be other dips, but maybe knowing how to manage them better will make it easier next time round. This might help others, if not thanks for reading my ramblings. Keep safe.
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