Today I watched a number of cardiac medical programs on Youtube and realised that most opinions relating the treatment of Coronary Artery Spasms include Calcium Channel Blockers. I have been prescribed the Beta Blocker Bisoprolol Fumerate 1.25mg which I understand from a number of the cardiac programs I watched, may actually increase incidents of Coronary Spasms which actually seems to be the case with me. I vaguely recall a patient mentioning this some time ago. Before I bring up with my cardiologist next week, can any one comment on this ?
Spasms. Beta Blockers vs Calcium Ch... - British Heart Fou...
Spasms. Beta Blockers vs Calcium Channel Blockers.
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Smileyian
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One comment. Stop watching YouTube. Dr Google or anything else that does not have your personal details. Even in Singapore (which I know pretty well) they keep your medical records
Gil
Thank you. Absolutely fantastic Cardiac Healthcare. The renown National Heart Centre here in Singapore has looked after me for 20 years during my many years with Afib hence I am most grateful. I don't see anything wrong or a problem with watching world famous heart specialists explain their views on the myriad of heart problems and potential treatments. Interesting 🤔
Ian. You just answered your own question. You are doubting your cardio consultant on the basis of watching you tube ? I assume you will inform them of this ?
Gil
I think it's the nature of having a microvascular dysfunction - our UK cardiologists are only recently becoming knowledgeable about the many conditions, not a lot of 'to the public' information is available here so many of us do tend to look for information where we can.
I (and Ian and many others here with 'unusual' conditions) are careful to click only credible sources like the NHS, the BHF, Chest, Heart, Stroke here in Scotland, and the very informative sources available online from the USA - the Mayo Clinic, Cleveland Clinic, Baylor, Harvard Med, Princeton...these are superb sources of further information for us as the USA leads in making reliable information 'to the public' available online for international reference.
I don't question my cardiologist's expertise and I feel sure Ian doesn't either - in fact, my cardiologist encourages me to use my bed-bound time to do research and he frequently takes on-board information I bring him. He especially likes the Mayo and Cleveland Clinics for new information.
You have absolutely put it in a nutshell Sunnie2day. Indeed UK is moving forward on this subject but the USA and Japan seem the preeminent players. It sounds great that a patient can bring points of interest to their specialist 😀 I acknowledge Gilrid1 points and there are indeed some rather dubious sources on line. We are all on here to help each other and share information to the benefit of all. Stay safe Sunnie and warm.
I almost hesitate to say this but will...I am definitely staying safe but if I could live in a freezer unit, I would!
My reading (especially in Latin American medical publications available to the public) is beginning to lead me in a very interesting direction - people who have had one or more of the tropical diseases (I've had Dengue Stage2, back in the mid-90s) are being discovered via anecdotal evidence to not only being prone to developing subsequent recurrent pericarditis (which I have, and have been counted in the Guatemalan statistics as being one of those who have had Dengue and gone onto develop recurrent pericarditis) but are beginning to be seen to develop microvascular dysfunctions as a consequence of the tropical disease case.
I have 'presumed' MVA (microvascular angina), and while I'm responding well to the treatment (1.25mg Bisoprolol+300mg aspirin+GTN prn) my MVA is 'presumed' until I can get in for the definitive diagnostic angiogram with acetylcholine provocation. When/if the diagnostic confirms my cardiologist's strong suspicion of MVA I will email the medics who treated me in Guatemala for that information to be added to their statistics.
Also very interesting anecdotal evidence are the consistent reports from recovered Dengue patients their newly diagnosed MVA is better managed and less painful when it's cold out - heat and humidity seems to be the trigger for painful attacks in these patients.
Like me.
If I could live in a freezer unit, I would!
Let me digest this and respond tomorrow as I also had Dengue 12 years ago. Interesting.
5 different artery spasm specialists from Japan, USA, London and Germany surely cannot all be incorrect . I will of course bring up next week but when I was prescribed, I believe the diagnosis of MVA had not yet been made. In fact it is currently still presumptive. I believe I meant it as a general question. I will of course discuss fully with my medical specialists. Take care as I know the pandemic is extreme in UK and I heard a few days ago that my 100 year old mother contracted Covid about week ago. I have just watched a most distressing Sky News program on your hospital situation.....just devastating.
Ian. At no time did I suggest any of the specialist where wrong ? I am however stating that none of them have first hand knowledge of your personal condition. I always check with people who have been involved with me directly. This is just my belief.
For the record on a lighter note on YouTube. 5 pundits tipped Liverpool to win the league and two tipped Chelsea (who have just sacked their manager) so called experts. It’s an opinion!
Gil
Gil how dogmatic to instruct a fellow reader not to take in the expert views of other cardiologists in the world not accessible otherwise.It is not up to you what he informs his cardiologist of or not.
I think you have missed the spirit of any of my replies. And after checking I don’t see a dogmatic? Reply or an aggressive answer from Ian unlike yours.
Yes I switched to Amlodipine from Bisopronol after having a stent to my LCX. After the stent insertion I had more angina symptoms but my arteries proved to be clear therefore the cardiologist concluded I must have spasms and switched me, I have to say it has definitely made a positive difference.
Smileyian in reply to
Thank you so much. I will follow up with my Prof at NHC next week. Are you confirming you have less attacks since your switch ? Are you able to advise if Bisoprolol Fumerate made you very tired and lethargic or was that not the case. I would very much appreciate any advice, however will be following up at my consultation next week.
in reply to Smileyian
Yes definitely less attacks and loads more energy.
Hi, I have e been re entry diagnosed with coronary artery spasms and I'm now on diliazem. I was told by my cardiologist that betablockers can actually increase the likelihood of spasms . I wasn't sure that the diliazem was making a huge difference and my GP put me on diazepam ( low dose ) and its made a huge difference - absolutely amazed how much better I feel. It really helps if you have a cardiologist and GP that understand the condition, I really hope you get the right meds that work for you.
Good luck..
Tks for sharing that Battle2020. So glad you feel better.
I have a LAD stent. After the usual meds I pushed GP for med review and reduced as many as possible . For a long time I was on just Amlopidine and was using a GTN spray when running or cycling. Recently my GP put me on low dose Bisoporol as well so as to reduce need for GTN. Was quite happy with one puff GTN before a run and it seem to stop the angina attacks. The difference I have noticed is that I do not get twitchy/ restless legs at night but i still use the GTN before a run as a precaution. I still enjoy my runs( well more like jog /walk) and thats the main thing for me.
Wonderful.
HelloInteresting use of GTN I didn't think it was recommended for pre-emptive strike against Angina or is it just MVA ??
Hands Face Space Vaccinate
Hiya, and my cardiologist is the one who advised me to use the GTN prophylactically. He said to use it before doing my twice daily warm-up and walks, and whenever it a confrontation (his word - stroppy) moment seemed imminent. He gave that advice before he started thinking my angina is MVA.
So far it works amazingly well - lol, recently my husband's and my cabin fever (loving the lockdown, not) threatened a bit of stroppy raised voices and I put my hand up, said 'Hold up, I need a hit of the GTN before we really get rowing!', we both collapsed onto the sofa laughing at the situation and ourselves.
But the GTN if things do appear to be contentious helps as much as it does pre-exercise. Lately the only time I've had an angina attack is if I try to move too fast or my recurrent pericarditis is about to flare.
The row bit made me laugh 🤣
I am particularly interested in your use of GTN prior to exercise or climbing hills. Although I will discuss this with my cardiologist on the 5th Feb, may I ask if using GTN twice daily or more prior to exercise or effort could potentially condition your heart / arteries to expect it ? Also is there a not a danger of actually overuse of GTN by pre-emptive sprays. Of course I am asking you Sunnie on the basis of your post and your advice that your Cardiologist suggested it. If I was confident enough to follow this suggestion, it may cut down my incidents of mild angina.
Hiya, Ian, sorry for the delay replying!
As for the 2ce daily GTN use, my cardiologist said it should be fine unless my angina began to hit during rest. He said if that happened I was to 'email with urgency' to let him know the nature of the angina had changed.
He gave me the impression I'd have to use an entire bottle of the spray in one day before it would cause a problem for me and as I only use it twice a day (dear husband and I rarely row 
) it really shouldn't be a problem unless, again, the nature of my angina changed from 'on exertion' to 'at rest'.
I should note here that advisement about 'at rest' angina doesn't apply, in his opinion, to angina that happens if the heat and humidity in the room I'm in happens - heat and humidity does trigger 'at rest' angina pain for me but as soon as the heat and humidity is reduced there is no angina pain. At first every time the heat/humidity rose and caused an attack I was emailing like mad, he finally said 'If lowering the temperature and or humidity in the room brings an end to the angina, you don't need to tell me about it'.
I now have a hygrometer and dehumidifier in every room of the house - if the monitor shows heat and/or humidity above my 'trigger levels' I make sure the dehumidifier is switched on. I do nicely at 19-21C with humidity at or below 50% and have trained myself to automatically check the monitors every half-hour or so especially in spring and summer.
Wonderful
We're all different so it is best to take only your medic's advise, let us know what he says about prophylactic GTN use in your case - I saw up-thread you say you are going to ask him about it.
I know in my case that little red bottle goes everywhere with me nowadays but I really only use it before exercise (or potentially contentious encounters, lol!).
Keep meaning to ask, how is your mum doing?
Hi Sunnie2day , i am still in hospital and have had quite bad spasm pains but ok now. Thank you so so much for asking after my dear 100 year old Mum. She appears to be completely over her Covid and is doing well. Will text when out of hospital. Seeing the cardiac team this afternoon. Take good care. X
I’m on the same amount of Bisoprolol. I was worried it was causing side effects and with the okay from my doctor stopped for three weeks. I felt my heart pounding away and felt out of sync so I went back on the same amount and feel much better. When I stopped my resting heartbeat went up ten beats per minute. Everyone reacts differently to drugs but listen to what the experts say.
I’ve had to resort to cardiac surgeons on YouTube due to the fact I can’t even get a phone call with him. All I have is the cardiac nurse who refers me to the cardiac surgeon. Forget asking the doctor anything as it’s a 3 week plus wait for a call back and that’s even if they call. I give up and stick to famous surgeons as they’ve helped me enormously. York cardiology and others are my go to people for help.I had a stent fitted last June and had nothing but problems with the meds and it’s taken me until now to deal with this by myself having to tell the doctors to try different things. Doctors....what doctors? I don’t have one here in Stockport so hope you out there are luckier than I am.
I am the sole carer for my 40 year old disabled son who has a severe head injury with the use of only one hand so you would think the health service and local doctors would have taken more care of us.
I’m angry and fed up and give up on doctors altogether. I wish I’d never had the stent and just gone on the Mediterranean diet instead since I never had a heart attack, just shortness of breath.
Sorry for the rant but I’ve nobody else to tell this to being isolated for the last umpteen months.
Have a great day everyone and stay safe.
Sunnie2day in reply to
(((HUGS)))
080311 in reply to
That is such a gut rending post, I am so sorry you have had such a terrible time.Don’t be sorry for your rant, you more than most needs to have a rant!
Wish I could say something to make you feel better, but know I am wishing you and your son well.
Pauline
GrannyE in reply to
I am so sorry you are in such a bad place. as far as I am concerned the more one can inform oneself the better. Sanjay Gupta is absolutely great. I do not believe in ignorance and sticking my head in the sand.
Different sort thing I know but sort of similar;
I've been on Bisoprolol for last 15 years. Had a PVI ablation for Afib 7 years ago which was successful but I've still had big ectopic beat symptoms since, on and off.
Recently, I've had to stop taking Bisoprolol because they have started causing very highly symptomatic PVC's ???
So when I stop them, I get my usual PAC's
which are pretty life altering. If I take a Bisoprolol, it gets rid of the PAC's BUT now causes these big PVC'S. ???
I had a A&E visit and the doctor said the ecg is fine and nothing suspect on it. But these PVC's have become very troublesome for me.
I can feel them and get wiped out by them BUT some people can't feel them at all!!!
Waiting to see a GP to see if I can get on a calcium channel blocker or something else.
On another note, when I was going back and fro the cardiologist before my ablation, I used to grill the EP/cardiologist with all this "information" I used to discover. He used to be absolutely thrilled with it all. The fascination with him was that he actually had someone to talk to in clinic that could put into "feelings" what he was seeing.
I remember one "Top" Cardiologist telling me that the Flecainide I was taking couldn't possibly be causing the effects I was experiencing!!!
I had been taking Flecainide for 5 years and on occasions was getting strange heartbeats and feeling dizzy!
I gave him a good roasting lol, I told him that for all his theory and education, he could not possibly be in a position to tell me how I actually felt!
He didn't like it and in a rage, ordered a treadmill stress test.
Of course, on the test, when my heart rate got to 130 odd, I went into this strange heartbeat, which turned out to be BROAD COMPLEX ARRHYTHMIA. Potentially fatal pro-arrhythmia from the Flecainide!!!
My GP from years ago, actually had to have himself, an Aortic Valve Replacement. He'd always had ectopic beats himself so actually somewhat sympathized with me. After his op, he went into Afib which lasted 6 weeks!!! He told me after he got well, that all the time he was treating me, he now knew how I felt and whereas he previously thought I was a little on the anxious side, he knew where I was coming from!
So a little information can be a good or bad thing. I think the worst thing we can do, is to become anxious at what we've read or seen on the internet BUT at the same time, definitely take it on board as a possibility. Difficult to be impartial and objective though when it becomes us on our own operating table so to speak.
Best regards everyone. Good health to you all and Love and Peace. There's always room for L&P I say ❤
Ian, I wonder if you could describe these arterial spasms? I have been on Bisoprolol for three months and frankly, every so often, I seem to go into a weird shivery state around my chest, neck and top of arms. My BP, temp and heartrate are all normal but I feel very unwell when this happens. I'm wondering if this could be similar to what you call spasms? I was very unwell last night with this.
I can but in hospital now after a wave of spasms this morning. Lights are out battery running out. There others on here can explain but I have no hp battery till tmw. So sorry.
Oh Ian so sorry you are having a bad time at the moment and in hospital. You must be very anxious about your Mother maybe that’s not helped.Sending you lots of best wishes and hoping you feel much better soon.
Pauline
Yes absolutely shocked. My GTN would not stop pain that came in 5 or 6 waves over an hour. I came to A+E as a precaution and was warded. 1st Trop is ok but will have lots of tests tmw. 11.30 pm here in Singapore and lights out. No battery left so talk again. Mum recovering. Thank you. No battery left now.
Wishing you a speedy recovery.
Cardiologist has put me on Pradaxa recently. I’m 75 yr male with pacemaker and glucose diabetes. I’m planning a flight to uk next year if COVID panic over. I had two jabs and felt below par for a couple of days and sore upper arm.I like naps during day now when it suits. Good health
I had coronary spasms after coming off mononitrate isosorbide. I went back on it at a high dose and then reduced down to 60 mg where I am fine. Beta blockers are the standard which doctors are taught to give but they are not necessarily the answer. The Consultants at the Heart hospital at Liverpool got me off them . The Electophysiologists in particular seem to not see them as the one size fits all solution which many cardiologists think they are. I was put on Amlodopine at one point but argued my way off it and have been fine. I have a pacemaker now and a stent and my problems have been a combination of the electrics of the heart and blocked arteries which in terms of heart doctors fall into two different categories. Both are very specialist. It is important to see a Consultant who is wise enough about both and who can think across both to identify your particular condition. Otherwise you will get a limited response into which prescribing beta blockers is seen as the only solution.
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