Change of Diagnosis

[Metal_lady]

I was diagnosed with Atrial Fibrillation on 26 June. Finally heard last week that Cardiologist had commented on my 7 day event monitor results. After 3 weeks of stress and anxiety. Increased symptoms and sleepless nights.Turns out its not Atrial fibrillation but normal sinus rhythm fast rate. So was due to start Metoprolol Tartrate 50mg, once daily. Except I take an ssri that interacts with it. The Gp, Practice Pharmacist and 2 Pharmacist's at Chemist let it be prescribed. So one letter gone to Gp and I complained to chemist and moved to another. I was weaning myself off ssri but I decided not to. So now am waiting on Cardiologist to come up with something else.

I'm a bit fed up.

[Milkfairy Heart Star]

Hello,

I am sorry that you are facing such difficulties.

Knowing why we have our symptoms is so important. I always find waiting for any test results stressful.

I live with a rare heart condition, I was initially misdiagnosed, so I acknowledge your feeling of being let down.

It's unfortunate that you haven't had a good experience of care from your GP and several Pharmacists.

I hope your letter to your GP is productive.

Are you able to discuss the issue with your GP?

Have you got a follow-up appointment with a Cardiologist coming up?

[Metal_lady in reply to Milkfairy]

I handed the letter to the Head Gp. I explained I don't want to activate a complaint, I just want them to learn from the chain of events. Luckily I've been a patient of his since he joined the practice. Luckily it's a practice that has several Dr's and they complete good notes.

[tachycardia23]

I often had a heart rate above 100 when simply sitting down, went to GP told him. He started me on 1.25mg Bisoprolol.

I found it wasn’t potent enough so we agreed to up it to 2.5mg. Next GP visit I suggested upping it to 5mg as there was still room for improvement.

He took my blood pressure said it was a bit low then gave me 2 months of 5mg Bisoprolol. I’ve since bought a blood pressure monitor to see what all the fuss is about.

In 9 days I’ve had it I’ve recorded BP between 98 - 108 systolic and 61 - 69 diastolic. So far touch wood never had less than 90 systolic or 60 diastolic which is low BP.

Now a good heart rate for me when sitting with my back supported is between 80 to 85 bpm. I’ve only been on the new dose for two weeks so things may change.

A friend of mine in Australia also had tachycardia, his GP put him on 100mg metoprolol but he found it made him lightheaded so he’s asking his GP to switch to Bisoprolol as I’ve had no such symptoms.

[Engineer46]

According to the British National Formulary (BNF) published by NICE, the SSRI Duloxetine that you take may increase the effect of a beta blocker such as Metoprolol, so the beta blocker dose should be adjusted accordingly. The BNF also states that the usual starting dose for arrhythmia is 50mg 2-3 times/day, so if you have been prescribed 50mg once/day it would seem that the dose has been adjusted to account for the possible effect of the SSRI. It appears that your GP may not have explained this to you.

Best wishes,

Paul

[Metal_lady in reply to Engineer46]

I don't take Duloxetine. I take Fluoxetine/Prozac. I've read the BNF, plus am an ex qualified psychiatric nurse. There is a concerning American study relating to a Liver Enzyme too.Therefore a different Gp is asking for an alternative drug to prescribe from Cardiology. My BP is well controlled by Losartan Potassium 25mg.

I'm more annoyed no one else picked it up. I'm even more annoyed I was told I had Atrial Fibrillation when I don't.

[Engineer46]

My apologies. I saw Duloxetine as one of your interests on your About page and assumed that was the SSRI you were taking. I hope that you manage to find a practical way to treat your tachycardia.

Best wishes,

Paul

[Metal_lady in reply to Engineer46]

Ah got you. I was prescribed it about 18 months ago, but it made me want to eat everything in sight. So I came off it slowly and went back on Fluoxetine. It's the reason I was a bit annoyed with Dr's and Chemist and practice pharmacist. However I now have another plan from head Gp to wait for further advice from Cardiologist. Thanks