New prescription - Diltiazem

[Heartfairy]

Hello I have been taken off Bisoprolol due to aches in shoulder blades (also have mild asthma) and now prescribed 200mg Diltiazem. However, during a recent visit to GP, he said I didn’t really need beta blockers as blood pressure and heart rate were in normal range but I then received a letter from cardiologist suggesting Diltiazem so a GP contacted me to say she would prescribe 200mg which I thought was a high dose initially. Anyway, after reading some of the side effects I’m quite concerned as I’m due to collect meds on Wednesday but I’m also due to fly to USA week after for a holiday. I’m reluctant to start new meds whilst going away so wondering if I should wait until I get back. I do have an appointment with cardiologist this week which I’m having to pay for as I can’t get any answers regarding the long term prognosis for my recent diagnosis of Moderate Coronary Disease. This seems a generic term but don’t really understand how much my artery has narrowed. I don’t need any stents at the moment and been told this will be managed with medication. This is all new, scary and worrying- I’m so scared of all the anticipated side effects of Diltiazem and don’t want to potentially struggle with them during an 11 hour flight to the States. Any suggestions on questions for the cardiologist?

[MountainGoat52]

I think that the best course of action is to air your concerns when you meet with your cardiologist. Delaying the start of a new medication seems sensible in this instance, but your cardiologist wIll advise. I found Diltiazem quite benign as a medication. However, I seem to recall that I was on 60mg and of course we all react differently to medication.

[Heartfairy in reply to MountainGoat52]

Many thanks for your reply GWP1952. I saw the cardiologist yesterday evening and after carrying out a little scan he said he was happy with my heart beat at 60bpm and my blood pressure 144/72 and felt that the Diltiazem could reduce my pulse too much and I didn’t need the medication for now. He confirmed I have <50% narrowing in my LAD and some mild narrowing in another artery but wouldn’t need any surgical intervention for now. Even though I’m in the normal range BMI I was told to lose weight around my middle - gosh easier said than done. I’ve lost weight everywhere else but now need to target the middle - any suggestions?? So I felt happier last night and relieved for the first time since this whole episode began back in February. I must now try very hard to simply keep this narrowing where it is and try and prevent further narrowing - again any advice would be appreciated. I’ve cut out meat and dairy so hopefully this will help. I need to work on my anxiety but i put this down to menopause and cardiologist said he wouldn’t recommend HRT, but I’ll see my GP to discuss options after holiday. Thanks again and good luck with your health issues. 😊

[MountainGoat52 in reply to Heartfairy]

I would think your blood pressure may be a little lower than the 144/72 as you were in a clinical setting and suffer from anxiety. I don't suffer from anxiety, but it is always around 160/80 when tested at the surgery or hospital, normally 130/70 at home.

I had a clot in my RCA, but the angiogram showed some narrowing of the LAD as well. As I was fit I was considered a suitable candidate for a bypass and referred to a consultant, purely for the long benefit. I opted for this. The consultant said he would probably need to stent the LAD inside 10 years, but if I had the bypass (which included bypassing the stented RCA), I should get 25 years before further intervention was required. Aged 65 at the time, that was good enough for me. 😃

[Heartfairy in reply to MountainGoat52]

Wow GWP1952 what a great result for you in the end! Well done you, I’d take that 🤣. My heart event happened age 55 walking up a hill, got out of breath and had a pain near my throat, knew it didn’t feel right so saw GP who sent me to hospital following an ECG in his surgery. Had echocardiograms, Angiogram, Perfusion scans and put on medication but following last night’s appointment I feel happier that I’m on just 20mg atorvastatin and 75mg aspirin- with no surgical intervention for now. So relieved. I just need to increase my aerobic exercise, cut back on the sweet things and continue with the reduction of meat and dairy. I feel reassured when I hear success stories like yours. Good luck with everything and thanks again for your encouraging reply. ❤️

[MountainGoat52 in reply to Heartfairy]

Yes, it's all good for me now. My GP refused to refer me for further investigation when I had rising blood pressure. He just prescribed more pills, so of which had an adverse effect. My HA was after a stressful period, but looking back had been on the cards for a couple of years. I used to need regular "pauses for photographic opportunities" when walking up hills. After my HA and stents that wasn't necessary and the situation is even better now. I now climb Munros up in Scotland... a couple in a day and I'm aged 70.

As for medication I'm on 75mg aspirin, 1.25mg Bisoprolol, 25mg Losartan, 10mg Rosuvastatin and Vit B., all taken with breakfast. It's a small necessity to keep the system ticking over. I try to avoid processed food, minimise red meats and I eat a salad pretty much every lunchtime, even in winter. I do everything else in moderation, enjoying the odd beer, glass of wine or a spirit - as I don't drink much, quality is more important. BMI is sitting nicely in range, but could be a little better. A day on the hills puts that to right!

I found for me the key to getting over my heart event was to remain positive. Keeping active has certainly helped and seeing how I am, the family is happy to let me get on with it. I hope it continues to go well with you and you settle into a routine that suits you... and you get back out onto those hills!

All the best,

Gerald

[Heartfairy in reply to MountainGoat52]

Thank you Gerald for once again, another encouraging reply. It sounds like you’re on top of the whole heart situation and are enjoying your life to the full. I’m just a bit of a scaredy cat at the moment and wake up each day thinking “am I going to have a heart attack today” - hopefully that will go and I will just get up and enjoy the day ahead instead of living in fear. I imagine anyone who goes through a health scare can feel like this. But you continue to climb those hills and fill those lungs with some good, fresh Scottish air. Keep well ❤️

[MountainGoat52 in reply to Heartfairy]

Yes, I'm on top of the situation, though I do realise that for me everything has been easy to deal with on account of the excellent care I received and the speed with which the sitation was dealt with. Unfortunately it is not the same for everyone and the current situation with our health service is really of great concern. All I can say is do what you are doing and I hope everything settles onto an even keel very soon.

Oh, and for any readers north of the border, I do like the occasional bit of haggis. 😆

[DD13]

Hi, I was on 160mgs of Dilitzem. Had no side effects. But if you don't get on with it, and need to come off these, make sure they tail you off them. Don't just drop from 200mgs to zero. Regards Dee.

[Heartfairy in reply to DD13]

Hi DD13 - fortunately I didn’t have to go on them following my appt with cardiologist yesterday so I was happy with that as he said my pulse and blood pressure were okay and the dilitzem could do more harm than good so just stick with statin and aspirin for now. Happy with that although I suppose it’s normal to always have a bit of fear at the back of your mind but hopefully that will go. The whole heart event was very scary although I’m lucky I didn’t have a full heart attack so I’ve probably been lucky that we’ve discovered the narrowing before it got fully blocked. Good luck with your heart health ❤️

[arTistapple]

Hi Heartfairy. Glad you got yourself sorted out. The main effect I felt on Diltiazem was a slow heartbeat. It slowed mine so much I could not get off the couch. Answer higher dose?? I chose to stop it and as DD13 rightly points out, come off it slowly. I did not and it was a truly horrible experience. The ones I was on were the ‘drip feed’ ones and they were a huge dose. Sorry I can’t think of the proper word at the moment. Life (for me) is considerably better without it.

[Heartfairy in reply to arTistapple]

Thanks for your reply - although at the present time I don’t need the meds right now just the statin and aspirin so I feel relieved at that. Good luck with your heart health and thanks for your reply ❤️

[Hidden]

just as a side to this I am on diltiazem 120mg per day with no side effects and it’s classed as a calcium blocker not a beta blocker( don’t know what the difference is lol) I was put on this as after a year of amlopodine my legs started to swell ,just know that due to having Crohn’s they are reluctant to put me on beta blockers 🤷‍♂️I have micro vascular angina and asthma as well