Ongoing investigations

Morning all,

I've posted on here before with regards to my journey over the last 2 years and the test results and investigations I've had.

I was told I had mild left ventricular hypertrophy (lvh), bradycardia with a resting pulse of 33, mild mitral valve regurgitation (mvp) with pulmonary and tricuspid valve leaking too.

My GP and Cardiologist have been great trying to get to some conclusion on the reasons behind my erratic heart rate, ectopic beats and palpatations and I've had many test done from bloods, ecg ,echo, exercise test, 24 hour monitor, mri scan etc with the results being as mentioned above.

I'm currently on 1.25mg of bisoprolol but I'm experiencing a slow heart rate of around 34 to 42 bpm and my blood pressure is ok at about 120/70 but I'm constantly fatigued and I have daily episodes of feeling lightheaded with a slow pulse and sometimes feeling nauseous while eating.

Recently I've had 3 episodes in work when my heart rate drops suddenly to around 38bpm while I'm working and i become fatigued and lightheaded, then I have terrible shaking moments and nauseous which can last for around an hour or so.

Two weeks ago while at work I had an episode again slow pulse and shakes which resulted in me going to A&E by ambulance to get checked over and my pulse dropped to 30 on route.

After 7 hours I was sent home after everything settled down and told to contact my gp about seeing the cardiologist asap.

Yesterday my gp has requested i have a 24 hour blood pressure monitor test and contacted the cardiologist to see me urgently.

Has anyone had similar experiences? or give us some advice as I'm feeling a bit confused as to what the problem may be or could it all be ok and just the bisoprolol making me feethis way?

Sorry about the long post

Regards

Taz71.

[10gingercats]

You seem to have a lot to contend with but it sounds to me as if as those trying to help you are doing the best for the moment .I guess it is wait and see what the cardiologist says and your GP has requested an urgent referal which sounds to me he is taking your problems seriously. Not much help I know when you are worried.You can always chase the cardiology dept. if there is no sign of an appointment within a couple of weeks and check they have received your doctors request and ask where you are on the urgent list.

[Hidden in reply to 10gingercats]

Hi,Thanks for your advice and I agree my gp has been great in trying to find out what the problem is so fingers crossed I will get an appointment soon as my next appointment is a telephone call with a valve specialist in April.

Regards

Taz71.

[RufusScamp]

That's a very low dose of bisoprolol, but we are all different in our reaction to drugs. It sounds as though local medics are doing their best for you.It might be worth having a chat with the BHF nurses who might be able to give you some guidance.

[Hidden in reply to RufusScamp]

Hi RufusScamp, i did speak to someone from the bhf last wk who recommended i have a 24 hour blood pressure monitor fitted to see if that's the reason why my heart rate drops suddenly so my gp he has now requested this to be done asap. I agree the bisoprolol is only a small dose and I cant see that being the cause of my heart rate dropping all the time but maybe it just doesn't agree with me? I'm tempted to stop taking it to see if changes anything but I know that's probably not recommended also the doctor at A&E told me to carry on taking it to help with the palpatations etc.

Regards

Taz71

[Hobbledehoy in reply to Hidden]

Don't do anything without Their knowledge & agreement !!

It is good to share on the forum, but over & above that, all specialised questions should be addressed first & foremost to the Medics.

Best wishes.

[RufusScamp]

I hope you get some satisfactory answers soon.

[lettingoffsteam]

Hi Taz,Why were you given bisoproplol? As a beta blocker it would slow your heart but I'm no doctor.I also have mild lvh due to longstanding undiagnosed high bp which is thankfully now under control.I take a tiny dose of propranolol (as I had some tachycardia) along with two bp meds.My heart sometimes drops to the low fifties but not lower plus I don't get the tachycardia which is great.I have a bit of arrhythmia too but not to be concerned about apparently.What are you getting? You definitely need to get some tests done so good for your GP.What was your pulse before you started bisoprolol?

[Hidden in reply to lettingoffsteam]

Hi, I've been on 1.25 mg of bisoprolol for around 18 months now ever since the cardiologist put me on it to help with my erratic heart beat palpatations and ectopic beats, then after having an mri scan and finding out I had mild lvh he increased it to 2.5mg to help ease the stress on my heart. I was then told to stop exercising as I was always out on my mountain bike and my heart rate would rise upto 225 bpm but settle at around 50 at resting. I was also told to stop drinking alcohol for 6 months which was not a problem as I never really drank much anyhow then after about 2 months he reduced the bisoprolol back down to 1.25mg as I was feeling rough all the time. Now 12 months later I feel like I've suddenly gone from someone being active and full of energy to now feeling tired and wiped out every day. I have a busy physical job but by the time I get home I'm falling asleep while watching tv and my pulse drops to around 38/40bpm. The bisoprolol has eased the palpatations and ectopic beats but I have no energy and feel lightheaded at times. Sometimes my heart rate drops then shoots up to around 150 and back down again for no apparent reason I feel sick and get the shakes. My blood pressure has never been a problem and sits around 120/70 but the doctor can't explain the bradycardia hence more test. My symptoms at the moment can be bradycardia ,tachycardia ,fatigue, breathlessness, nausea, palpatations, shaking and chest tightness but not all at the same time thankfully. Hopefully I will find out more in the next few weeks. Regards

Taz.

[ETHEL103 in reply to Hidden]

Hi my hr spikes for no reason too.Luckily it was caught on an ecg at the hospital and it was atrial flutter.It makes me feel very light headed and hot.I have to sit till it passes.I also suffer with ectopics and persistant a fib.The flutter is definitely a horrible e penitence.I have a kardia but it doesn't seem to show flutter only possibly a fib.If you send away for a revue it then may come back flutter.

[Hidden in reply to ETHEL103]

Hi, when my heart rate drops Into the 30s i feel lightheaded and have to sit down and then when I goes up I feel like my blood is boiling/warm if that makes sense. I still get the palpatations and ectopic beats but my bp is ok.Regards

Taz.

[lettingoffsteam in reply to Hidden]

That sounds difficult to live with.Hopefully your tests will reveal what is going on.

[Hidden in reply to lettingoffsteam]

Unfortunately its something I'm sort of use too at the minute as it happens daily but its worrying after having 3 big episodes at work, with terrible shakes and turning very grey. All my work colleagues and on site medical team was worried hence the trip in the ambulance to A&E.Regards

Taz.

[lettingoffsteam in reply to Hidden]

Yes, that's very concerning.Keep us posted.

[fairgo45]

I've just been posting a similar set of symptoms very low heart rates and then spikes of high rates a long time afib sufferer I had recently had a 48 holter monitor because I was finding the low rates making me lethargic and breathless. The holter showed 100000 PVCs each day with pauses of 3.4 all through the 48hours.

I'm being considered for a pacemaker as meds are not helping.

If you haven't had a holter monitor yet ask for one then they will know exactly what your heart is doing

[Hidden in reply to fairgo45]

Hi, thats a lot of PVCs you must feel terrible at times? I have had 2 holter monitors fitted over the past 2 years showing frequent ectopic beats /PVCs at 2% but I'm not sure if that's ok but it always felt like my heart was about to jump out of my chest and you could hear the gulp/woosh as it beats out of sync with long pauses, slow then fast beating etc. I hope you get things sorted out soon with the meds or pacemaker. Regards

Taz.

[richard_jw]

The idea of a beta blocker like Bisoprolol is specifically to slow your heart rate. In doing this it can lower the BP. Your BP seems OK, but pulse is surely too slow.Do you know the specific reason why you are on a small dose of Beta blocker?. My uncle also had Bradycardia. Uldimately they fitted him with a pacemaker

[Hidden in reply to richard_jw]

Hi, my bp has never been a problem and I was originally on 2.5mg of bisoprolol but the cardiologist reduced it as I was having issues with the higher dose.

Regards

Taz.

[richard_jw in reply to Hidden]

When I was on 2.5mg of Bisoprolol, my resting heart rate was around 55-60. When I came off it, resting heart rate went up to 75. Coming off a beta blocker will increase your heart rate. Yours seems to be very low. There may well be a different reason for the Bisoprolol, so it might be a good idea to ask your doctor. I'm not a doctor, so you need advice from someone qualified.

[Hidden in reply to richard_jw]

Yeah I think they want me to stay on it till they do more test.Regards

Taz.

[Hidden]

I know having mild lvh and mild mitral valve regurgitation with a trace of pulmonary and tricuspid valve leaks too are probably nothing worry about and some people can live with it without any problems or treatment etc. But I'm having bradycardia each day, feeling off most days while trying to work and still carry on but when you know something isn't right makes you question things plus going from being a very active 50 yr old to now feeling tired most days not wanting to do much exercise anymore.

Low hr reading from the past.

[Qualipop]

Good luck finding the cause. I was like that on bisopralol. It dropped both heart rate and BP so low I was asleep most of the day. Same low dose as you. I just don't tolerate beta blockers.

[Hidden in reply to Qualipop]

How much bisoprolol was you on? Did you change to another med? Also why was you on it if you don't mind me asking.Regards

Taz.

[Qualipop in reply to Hidden]

I was on 1.25 bisopralol. GIven it after a heart attack and 2 stents . I think it's just the standard set of meds they give to everyone. It was changed to Candesartan but I didn't get on with that. Because I also take a diuretic , that was keeping my bp stable on its own so I now don't take any tablets at all to control BP.

[Hidden in reply to Qualipop]

Sorry to hear about your heart attack, glad you have everything under control now med free.

[Chickenlou]

My fiancé has had similar problems with bisoprolol.

He was initially prescribed it at 5mg a day whilst waiting for his heart bypass in 2020 - it really slowed his heart rate down to high 30s/low 40s but the cardiologist seemed quite happy with that as he had 3 blockages in his arteries at that time and they felt that the low BPM was acceptable compared to the risk of not taking it.

A few months after his bypass his consultation took him off the bisoprolol as it was still causing very low BPM even on 1.25mg.

Then he started to have irregular heart beats and has been put back on it pending investigations. Again his heart rate is now low 40s at best. He feels tired all of the time and has no energy or “oomph” to do anything.

He is due to have a 72 hour monitor next week, so hopefully that should tell us more about what is going on.

Fingers crossed you get some answers too.

[Hidden in reply to Chickenlou]

Hi, like your partner the doctor at A&E questioned why I was on bisoprolol and wanted to take me off it to see if my heart rate increases but decided against it as I would probably get more palpatations etc again. I hope your partner finds out more from his monitor readings, im waiting for a 24 hour blood pressure monitor so hopefully I will know more soon....good luck.Regards

Taz

[Dollcollector]

Even a small dose of a beta blocker can make your pulse drop to low and make you feel wiped out. If your pulse already is very low ( bradycardia) l would have thought you would have had a pacemaker recommended.

[Hidden in reply to Dollcollector]

I was told I have bradycardia resting at 33 after my holter monitor results but because of the palpatations/ectopic beats and lvh the cardiologist put me on bisoprolol. With any luck I will be having more test soon and maybe have a clearer idea on what to do next.Regards

Taz.

[Dollcollector in reply to Hidden]

I would have thought taking a beta blocker is the worst thing you can do. I also have thousands of ectopics which they say are harmless. I also became tachycardiac with the a,f. My pulse used to surge between having bradycardia , when l would have blackouts and tachycardia. The idea was to Implant a pacemaker to stop my pulse going too low; then l could take a high dose of a beta blocker to stop it going too high. Since l have had the pacemaker l haven't needed the beta blocker though as l haven't had the electrical surges, which sometimes happens.... hurrah.

[Hidden in reply to Dollcollector]

Maybe that's my next step all will depend on the cardiologist and his findings. Glad to hear the pacemaker is working well maybe that's what I need.Regards

Taz