Slow irregular and missed heart beats

[Howdenhall]

My husband has been on Ramipril for 14 years, together with bisoprolol, aspirin, atorvastatin and Famotidine, without any side effects. However, 3 months ago, he started to have episodes of a slow irregular heart beat around 40 - 45 beats a minute with missing beats. The first 2 visits to A&E a week apart, found nothing conclusive, after an ECG and blood tests. 4 weeks ago he had another episode, quite a lot worse this time. Went to A&E, ECG and this time, bloods showed a significant rise in potassium level. Given an infusion of glucose and insulin, and a nebuliser, but not sure what that contained. Admitted to hospital overnight for observation, and cardiologist thought it was most likely to be Ramipril causing it, and changed the drug to Amlodipine. He was also given a Holter monitor to wear for 3 days last weekend, although the results of this will take a couple of weeks. He has been having palpitations with a couple of missed beats about once a day but only lasting a couple of minutes, before it passes.

Has anyone else experienced this with Amlodipine, and will it pass in the end once his body gets used to it. They say it can take up to 4 weeks to finally get rid of Ramipril, and for Amlodipine to take over. Slow and missed heart beats are very scary, but must be patient until he has an appointment with the cardiologist, which can be 4 to 5 months.

[Tlyna]

I was on Ramipril for some time and ended up having the same symptoms as pulmonary edema and heart failure. I was taken off it and the symptoms subsided for a time but then came back with a vengeance leading to a trip to the ER and then a TAVR. The Ramipril was either masking the heart problem or actually caused it, no idea which but I will never take that stuff ever again.

[Howdenhall in reply to Tlyna]

I’m so sorry to hear of your experiences, and hope now you are feeling much better.

It’s a scary old time, but so grateful for the NHS, which we cannot fault.

[Tlyna in reply to Howdenhall]

I wish I had NHS but sadly I am in the US and our insurance isn't so hot over here. I am lucky I even have insurance at all and our right wing politicians want to remove a big chunk of it (Medicare). They try to claim it is like welfare but ignore the fact that we pay for it with our taxes so it isn't as if we are getting something for nothing.

I am doing much better thankfully but that was a really scary experience. The TAVR was actually the least traumatic of it all and I felt 100% better right after I woke up from it.

[Howdenhall in reply to Tlyna]

I hadn’t realised that you lived in America, but we hear quite a bit on our News about your health care systems. It must be really worrying for you at times, but very glad that the TAVR has helped you so much. As you say, you have been through a very scary experience, which can be quite unnerving, but come out the other side. We are just hoping that we won’t have to wait too long for a diagnosis, but I gather it could be about 4 months time. However he feels much better having come off Ramipril, although is still having some palpitations, possibly from Amlodipine. Must just be patient!

[Tlyna in reply to Howdenhall]

Hopefully his side effects will subside. It took a bit before all my reactions went away. They were nasty the worst being shortness of breath and heart palpitations. I had to go through several tests over a couple of months before they settled on the diagnosis and how to deal with it. I was lucky not to have any plaque build up in my arteries or I would have had to go with open heart surgery as both my parents did. Yeah all three of us had the same valve malfunction.

Our health insurance problem here is horrendous. I am lucky to have both Medicare and a policy from my former employer but many work places no longer offer insurance. Medicare is considered primary coverage with Blue Cross covering part of what is left leaving me a copay than can add up quite a bit. If our politicians cut out Medicare millions will be without coverage at all. I really envy you having your national health care.

[Sambobs17]

hi Howdenhall sorry your husband is experiencing all this as I’m having the same symptoms I can understand how he feels, just been diagnosed after 24hr ecg with bradycardia and PVC’s I’ve been on sotolol (anti arrhythmic) for a number of years and amlodipine for about 10 years I think the combination now is too much with regards to slowing everything down so I’ve been advised to stop the amlodipine for two weeks to see how things go - I’m also waiting for an echo appointment which apparently has to be activated from being requested 6 weeks prior so I’m hoping I hear next week as the 6 weeks is up - everybody is different of course how they react to medication but hopefully your husband gets some answers soon 😊

[Howdenhall in reply to Sambobs17]

Thank you so much for sharing your story with me. I hope very much that you will hear about your appointment very soon - the waiting time has mixed blessings. You hope that the longer you wait means it may be better news, but if it’s sooner, they feel there must be some urgency about it. Have you felt better having come off Amlodipine? I must say how grateful we are for the NHS, and cannot fault them. Just have to be patient with waiting times, and know that there are so many of us all in the same boat, hoping to be seen soon.

If you would like to say how you get on, I would be very interested, but please don’t say if you would rather not. I would fully understand. However very best wishes.

[Sambobs17 in reply to Howdenhall]

Hello Howdenhall by all means I will let you know how I get on - I suppose it’s early days with me regarding stopping the amlodipine can’t say I’ve noticed much yet it’s only been a couple of days - think I’m happy to try anything at the minute in the hope they will calm down - the Nurse Practitioner I saw did say the big delay with cardiology in our area (Rossendale) is due to Afib and the amount of cases that’s doubled since covid - my husband had the same issue he didn’t notice anything but he already has a pacemaker - (we have both had covid) I just might know more once I’ve had the echo but obviously it will be waiting for the result but any changes I will definitely let you know, in the meantime hope your husband gets a break soon it’s so tiring take care 😊x

[Sambobs17 in reply to Sambobs17]

Hello Howdenhall just thought I would send you an update with regards to stopping amlodipine- it didn’t make any difference to my slow HR but my bp did go up so I went back on them - in the meantime I had still not received an appointment for my echo having contacted the hospital to see where I was on the list so I was originally told it would be a 6 week wait from the referral as it happens it’s 15 weeks ! And not feeling any better I decided to go private, I had that done last Wednesday I’m due as well as my GP to receive my results on 7/10/24 - they can only refer me to advice and guidance (cardiology) along with the test results I had my 24hr ecg (NHS) so I’m hoping that referral goes ahead next week - I’m lucky I have an excellent Advanced Nurse Practitioner who has been helping me through this which I’m really grateful for hoping your ok take care 😊x

[Howdenhall in reply to Sambobs17]

Hello Sambobs17, I am really glad you are at last getting the help you need. I hope Monday’s appointment goes well. We have been wondering whether to have a private appointment - but we have been able to arrange a telephone consultation on Wednesday with our GP, so will see how that goes. I don’t feel you can have a natural conversation under those circumstances, but better than nothing. We were wondering whether there maybe a Cardiac nurse in the practice - it would be lovely just to have someone to talk to, which is why I so appreciate you sharing your experiences. It’s a lonely old world out there when you are really worried, and not able to get the help and support you would like. However, very best wishes for Monday, and would love to know how you get on, if you felt like saying. Please don’t if you would rather not.

[Kaydee24]

I don't know that I can be of any help, having not been on Ramipril or Amlodopine; I am on bisoprolol, aspirin, clopidogrel, famotidine and atorvastatin. I get occasional "missed" heartbeats, which I hope are due to anxiety, but have not to date had any episodes of slowly beating heart.

[Howdenhall in reply to Kaydee24]

Thank you so much for your comments - sorry I have taken so long to answer! He was going quite well on Amlodipine for a week or so, but is having slow and missed beats again, often in the evening when sitting quietly. They last for about half an hour, but it always sets him back, particularly when he feels he is getting used to the tablets. It’s a roller coaster ride for both him, and for me, as neither of us can understand why it happens. In between times, he feels fairly well, and can exercise and walk without chest pain or breathlessness. Thank you so much for sharing your thoughts with me - it really does help x