Slow Heart Rate

[Channeal]

I am a 71 year old female and I am on the following drugs:-

Atorvastatin

Amlodipine

Indapamide

Losartin

Levothroxine

Omeprazole

Bisoprolol 2. 5 mg

Aspirin 75 mg

In 2019 I had an operation to repair an inguinal hernia. This was delayed for about six months as they discovered some kind of abnormality in the ECG they did at my pre-op check. I then had to see a heart doctor who sent me for a echogram which was okay. After waiting for all this, I finally arrived for my op. They however did another ECG and panicked again! I was told I couldn't have the op, but was sent off for an immediate angiogram. This showed no blockages - and they relented and I finally had my (badly needed) op. All I have ever been told about the abnormalities on my ECG is that they probably related to a time when my BP was not controlled.

Why I am writing now is because since 2013 approximately I have been feeling unwell when I wake up after about six hours sleep It is hard to explain exactly how I feel though. I have seen a few different GPs about this and they have tried things such as increasing my BP meds and putting me on thyroxine. Nothing has helped. Last year, I tried again and the doctor I saw said it was due to stress (I am stressed, but wasn't when this problem started). Apart from BP meds, nobody has ever suggested it could be anything to do with my heart.

My question is, would the ECG irregularities cause any symptoms. Also, I have noticed when using my BP monitor that although my BP is always okay, my heart rate always seems very low, usually in the 40s (though am not sure how accurate this is in home machines). Am wondering if this could be related to me feeling ill when I wake?

[Becdan]

Hello Channeal

Sorry to hear that you have felt unwell for so long.

Bisoprolol could be the cause of your low heart rate. I take 2.5 mg and my heart rate is in the 40's or 50's when I check my blood pressure and can also cause tiredness.

With such a cocktail of drugs to take daily, this could be why you are feeling unwell in the morning.

Apparently it is quite common for people to feel a little queasy when they wake up in the morning because of the meds, but I am no doctor.

[Channeal in reply to Becdan]

Apologies.... I really meant to say that I only started the bisoprolol and the aspirin after the first ECG in 2019. It was kind of a condition for them agreeing to operate that I should start on these drugs. I had been feeling ill in the mornings for several years by then though.

The outstanding characteristic of this feeling ill is the fact that in order to feel better, I have to raise my head and shoulders. If I remain lying down completely, then I do not feel better. I then have to stay awake for at least an hour before I can go back to sleep without feeling ill again.

[Becdan in reply to Channeal]

Hello again.

This sounds more like a gastric issue to me as this is normally eased by elevating your head and shoulders but I really am guessing here.

Hopefully someone more knowledgeable will be along soon and may be able to offer you some more helpful advice.

It does seem like you may need to speak to your GP to get a proper diagnosis to stop you feeling ill every morning.

Hope you get it sorted. Take care.

[Channeal in reply to Becdan]

The idea that this could be gastric in origin has never been mentioned - but it is a possibility as I do get lots of gas in my stomach every morning. Thank you for your help.

[Ticker1234]

Hi, my cardiologist said my heart rate was too low averaging 46 bpm so has taken me off Bisoprolol 2.5 mg saying having such a low resting heart rate could lead to having a pacemaker fitted if it continued at such a rate.

I cut the very small tablet in half and took it for a week and have now stopped it completely. My resting heart rate is now 60 bpm and I have a health watch which shows my heart rate which I keep an eye on when on my treadmill.

I am a 73 year old male in otherwise good health after having 2 stents fitted.

[Channeal in reply to Ticker1234]

Thank you, this is very interesting. I really need to make a list of all these points and try to see a doctor. Hopefully next time I can see somebody who doesn't dismiss all my problems as being caused by stress!

[fishonabike]

Hello

as an ex-nurse with a heart condition i look at your medication and think "that's a lot of Hypertension medication!"

Amlodipine, Indapamide, Losartan, and Bisoprolol are all aimed at keeping your blood pressure down and the norm is to take any 2, so i'm surprised to see that you have been prescribed all these. These would all affect your heart rate, keeping it lower and steadier.

The Levothroxine is a medication for people with low thyroid activity and this condition can lead to a slow heart-beat

Atorvastatin is a statin, as you have no apparent blockages this is prescribed as a preventative measure, along with Aspirin as an anticoagulant - the Omeprazole is often prescribed automatically with aspirin to prevent stomach damage by aspirin

I can't answer your question about why you feel unwell in the mornings, but my first step would be to ask my GP why all these medications have been prescribed as well as what they are meant to be treating as it seems that this has not been explained yet.

[Channeal in reply to fishonabike]

Thanks very much for your reply. First of all, I was put on amlodipine, then some time after, on indapamide (or it could have been the other way round, I can't remember which came first). Eventually, I was put on losartan because by bp went up again. It has been very stable since I started the losartan. It was the hospital who put me on bisoprolol and aspirin in 2019 after the ECG showed the irregularities. They said they would only do the hernia op if I took these drugs. The doctor who did the angiogram on the day of my op said that I should continue with these drugs after the op.

I believe that the omeprazole was prescribed while I was enduring the long wait for my hernia op. I was having frequent pain and vomiting with it and it messed up my stomach a lot. I thought it was only going to be temporary, but nobody has reviewed the situation since.

As far as the levothyroxine is concerned. I was put on this because a doctor thought that my thyroid levels (although they were only borderline at the time) could be causing me to feel unwell every morning. It didn't help at all with that though!

[fishonabike in reply to Channeal]

sometimes it is helpful to have a medication review - doctors are good at prescribing medication but not so good at stopping or reviewing it without prompting

over-medication is common and unnecessary, it also increases the chances of experiencing unpleasant side effects

re- levothyroxine, maybe it's time you were properly assessed by an endocrinologist, and as DenBoy says, you should be having regular blood tests to monitor kidney, thyroid, and liver function among other things

[Channeal]

It is incredibly difficult to describe how I feel. It feels as if something is going on inside, either like a vibration or an electrical current. But mainly, it is just a horrible sense of feeling generally unwell. It also feels as if I have been through something really traumatic. For a long while, I was convinced I was about to die - but so much time has passed now and I feel a bit less worried about that.

As far as heart failure goes, I don't know a great deal about how that is diagnosed. Is it possible that I could have had that all this time, but that it was not detected in either the echocardiogram or the angiogram, or when my heart was monitored during my hernia op? Please tell me if this could be the case.

[Hidden]

Hi,

Having read your post and the responses I wondered if you have had a blood test recently. I have one each year arranged by my GP which can show anomalies or problems.

My last test showed that I had a very high bnp level which is a sign of heart failure and I was sent to the local hospital to have an echocardiogram which is how they can tell wheither you have heart failure or not.

In my case I didn’t have heart failure and the high reading was presumed to be caused as a result of my other illnesses.

Well worth having a full blood test which is simple for your doctor to arrange and which may give an indication of what is behind your feeling of being unwell. If it comes back all clear then it does suggest the cocktail of medication you take may be causing it.