LBBB Ejection Fraction advise please?

[honeybubs]

just been diagnosed with LBBB Ejection Fraction 35. Waiting to start tablets Ramipril then Bisoprolol. If anyone who has experienced this with these tablets could let me know how they got on I would be very interested in hearing about it and any advise or questions I could ask my cardiologist would be very helpful thank you.

[Motorman]

I take both, they do make me a bit tired and for that reason I take the Bisoprolol at night (5mg) my GP is OK with this. MM

[honeybubs in reply to Motorman]

Thank you much appreciated for letting me know.

[Qualipop in reply to honeybubs]

I was also extremely tired on b isopralol; had to stop it eventually as it was dropping my bp too low. I'd definitely take it at night and keep a check on your BP. No other side effects.

[mmmb]

On the same and had sub 40 EF ...

The Bisoprolol slowed me down a lot ... in the end I split the dose (AM/PM) which helps (though you need the dr. to say you can do that!)

ps. through exercise / diet and luck I'm now at 50 EF and discharge (on the drugs for life though ... but it's going to be a lot longer life!!)

[mmmb in reply to mmmb]

also was on 5MG, persuaded Cardiologist to reduce to 1.25 x 2 after the EF improvement ... that got me running faster

[honeybubs in reply to mmmb]

can you let me know what exercises you do? I walk the dog twice a day and since losing my business due to covid instead of sitting at a desk working I’ve been helping old people with shopping housework and ironing etc but some of them have gone into care so I’m down to two now and my 93 year old mum so I think that is good exercise but I think I should be doing more? I’m very determined to better things I have will power. I was pre diabetic (42) and got it down to normal (38) in a matter of weeks with a good diet and intermittent fasting so I sm very interested in how you managed your heart failure and are making it better. Please share as much info on how you’ve done this please. Thank you in advance. X

[Zundap]

I am on both (1.25 mg) and have been on them since 2017. I did have a cough when I started but this has now gone. I do get a little hoarse in the afternoon and also feel a bit tired in the early evening. I take my meds in the evening.

[LindyMc in reply to Zundap]

Interesting about the hoarse voice. I got referred to ENT to check for nasties as my GP hadn't come across that as a sideffect. I have been refereed to speech therapy to try and resolve strained larynx , no nasties found.

[LindyMc]

I had to reduce my bisoprolol from 5 mg to 2.5 and now on 1.25 as my RHR went from top 50s to 40s which i could not tolerate as it made me so tired that it was becoming impossible to carry out my full time caring role. I am easing in to pill in the pocket, while maintaining the apixaban

[Finaus]

What is your diagnosis other than left bundle branch block? Do you have heart failure and if so how severe is your condition? Why are you being prescribed to take the drugs? What are the drugs intended to achieve?

[honeybubs in reply to Finaus]

hi yes it’s heart failure the ejection fraction is 35 which is too low. Due to heart muscle weakness. I am having syncope fainting episodes. The echocardiogram showed up the weak pump function of the heart. I was only given the results a few days ago so still waiting for my GP to organise the tablets. I know I’ve had this coming on me for longer than 10 years with symptoms but nothing was done because of lack of evidence so I’m upset the problem has got this bad and I feel I wasn’t believed. Anyway I just want and need more information from people who have actually been through this to help me on my journey. Thanks

[rizal in reply to honeybubs]

Yes it is HFrEF, heart failure with reduced ejection fraction. I am living with HFpEF basically your heart draws in sufficient blood but pumps out too little of it each beat, with pEF it draws in too little but pumps out the correct proportion of it. Both lead to the same result. I am on the same meds as you at the moment plus a whole lot more. Can I suggest some reading for you to help you understand better. pumpingmarvellous.org/heart...

On that page are links to several online leaflets which will explain a lot about various aspect of living with heart failure, what it is, meds and other treatments etc

[honeybubs in reply to rizal]

thank you I will have a read I really appreciate everyone’s help.

[B10D]

Post aortic valve replacement I was on 2.5mg Bisoprolol to manage some ectopic beats. This had the effect of bringing my blood pressure down to normal but also brought my resting heart rate down to under 40 overnight. Dosage was changed to 1.25mg which meant my resting heart rate only went down to about 45 overnight but my blood pressure increased with diastolic of high 90s. Then prescribed Ramipril 1.25mg in addition and my BP is now back to normal. I have no perceptible side effects from either medicine.

[Familyk]

Hi,I'm currently taking losartan as I couldn't tolerate ramipril. My blood pressure dropped far too low. My EF is currently 32, diagnosed 3 weeks ago with dilated cardiomyopathy and heart failure. Have felt like the walls are closing in on me.

I like you are just starting my journey.

Sending you lots of positivity

Stay in touch

[Raznic]

Hi there honeybubs, I am also living with HF, co-incidentally have the same EF. I am on 2.5mg Ramipril daily and 7.5mg Bisoprolol (2.5mg mornings 5mg evenings) as well as apixaban. Also have a CRT pacemaker fitted (five years now). The Ramipril hasn't caused any problems that I am aware of. The bisoprolol initially made me very tired, I was on 10mg daily single dose at first. This was reduced to my current level but split into two doses daily and over a little time, although I still get tired it is nothing like as bad. The major issue with me and Bisoprolol is the constantly running nose. A known side effect that sounds amusing but is very annoying, just have to live with that. Probably a small price to pay, and we do get used to almost anything. Good luck.

[honeybubs in reply to Raznic]

hi Raznic I’ve been told I may need a pacemaker but it seems very scary having wires in your heart I’ve looked at diagrams. How long does it take to get used to it and does it make you feel better straight away?

[Raznic in reply to honeybubs]

Hi honeybubs, Yes it is a bit scary when you are first advised about the need for a pacemaker. But I can honestly say that the actual procedure was much less scary than anticipated. I had mine done at Papworth, and everyone was brilliant. Home the next day. And yes, my beathlessness disappeared immediately, and once the initial site soreness wore off I now am hardly aware of it and do feel much better. Hope this helps.

[Andian]

Morning, I started feeling unwell in March of this year and after a visit to GP given 1.25 Bisoprol and Ramipril. An ECG showed LBBB which had been there for 10 years apparently. He referred me to Cardio but due to waiting list I went private. Went through tests but by August very unwell and had a HA. Lots of the usual medication now of course as Heart Failure. The Bisoprol and Ramipril are gradually being increased at 4 weekly intervals when for a couple of weeks I feel very tired, then it wears off a bit, until the next increased prescription. I would rather feel tired and know I have something helping to keep my condition on the best lines possible. Best of luck with your health, keep taking the pills.

[Andian]

Interesting to read about the runny nose, I have this continually but thought it was old age lol.

[Harefieldfan]

Excuse my ignorance, but what is 'ejection fraction'? Thanks

[RufusScamp in reply to Harefieldfan]

It is a measure of efficiency of the heart pumping action, and should be in the range 55 to 60%

[Harefieldfan in reply to RufusScamp]

thank you! Had never heard of it.

[honeybubs]

it’s the weakened ventricles not pumping the blood through the heart properly as the muscle has weakened I’ve been told it’s hereditary. I’m sure someone else could perhaps explain it better. I’ve only just been told so I’m learning about it.

[TheBoys]

hi

I really wish I could help a bit more but your post has actually helped me a lot.

I was prescribed 5mg bisoprolol following recent hospital stay as a consequence of suspected clot - with tachycardia.

With no diagnosis yet as there was no clot etc etc . I was sent home with the 5mg biso.

I found I was slowing down to the point where I could hardly feel myself breathe. I ended up frightened to sleep / setting the alarm every 30 minutes at night as my pulse was down to around 45 at night which scared me.

I’ve raised with GP etc and just been slapped down and ignored so now cut the 5mg into 2.5.

Hopefully I will see a cardiologist soon to get some sense. But 5mg Bisoprolol is deffo very scary as a med.

[Raft]

Hi, I have been on Ramipril for 3years gradually increasing dose from 2.5 to 7.5, also on Bisoprolol 2.5 and spica am.

Have a runny nose from time to time, but this may also be from eye drops for eye probs.

Otherwise no other side effects that cause major problems. I am 83 and have other medical issues so can never be completely sure what is causing side effects🤷🏽‍♂️but believe my heart meds are doing a good job.

Best wishes for your future😋

[TheBoys]

anyways hope all goes well for you and take care.

[Cruiser25]

Really interesting reading all the replies. I too take both Ramipril and Bisoprolol after a HA earlier in the year. This left me with 38% EF. Again like most I started on 5mg then 2.5mg, now 1.25mg as Bisoprolol is one powerful drug. My BP dropped stupidly low before the reduction, now lower end of normal & sleeping heart rate mid 40s...which is fine for me.

An adjustment of the meds is really common & nothing to worry about, you'll soon find what's best for you, whilst ensuring they do their job.

Side effects... cold hands, occasionally runny nose & the odd bloody nose blow...but this is the Aspirin & anti-platelets.

Get stuck in to rehab, it's amazing how this, along with the meds & dietary changes seek to improve your EF.

Good luck...embrace the new you

[RufusScamp]

was diagnosed with severe heart failure (EF20%) and LBBB 3 years ago. I was started on Ramipril and Bisoprolol for 6 months, then I had a pacemaker fitted, which I mostly forget about! I am now on Entresto instead of the Ramipril, and my EF has improved to 60%.

Your cardiologist would not suggest a pacemaker if they didn't think it would help you. It is really no bother, especially as it can be monitored remotely, so less hospital visits.

I do feel very tired mid-afternoon, which I blame on the Bisoprolol.

[RufusScamp]

Naughty consultant! She told me 55%+.

[Eldot]

This thread has been most interesting. I am in my late 60s and am fairly active. Last month, on holiday to England, I suddenly started feeling faint, usually shaving but once in the fast lane of the M25, so I submitted to the nearest A&E. I have "NSVT leading to presyncope" with an EF of <25%. I am on 2.5mg Bisoprolol am and pm and Ramipril pm. My resting HR has always been the high 30s to high 50s with typical BP of 120/65. I was fitted with an ILR. Now at home I have had no further faints or any other problems and have resumed my walking, cycling and swimming AND I FEEL FINE.

We're all different and react differently to different levels of medication. Think positively- it actually helps. I'm dreaming of having an EF as good as yours.

[Bobkins99]

I had Mittral repair in July. I was diagnosed with moderate heart failure post op and put on a big regime of pills. Slowly over the months we have worked out what's best and when to take them. So to start it was aspirin, ramapril, bisoporol,empagloflizin, spironalactone and lanzoprazil. The ramapril have me a wierd taste so was changed to candersarten, the bisoporol gave me big postural BP drop so was split between morning and evening and the lanzop and spironalactone gave me the trots so the aspirin was changed to Apixaban and the lanzop and spiro both discontinued. All seems good so far but it has taken 4 months of trial and error so funny be afraid to talk to your heart team/GP/pharmasist