Severe fatigue while on heart medication

[Morningrise]

Had a pacemaker implanted 2023, and have been on associated medication since. I've been suffering from extreme fatigue and dizziness since, despite the medication being tweaked several times.

Eventually, full-time work became untenable and I dropped to part-time.

However, the fatigue I suffer is making even 20hrs a week difficult. My employers are sympathetic (thank goodness), but I've had several periods of absence.

Is this level of fatigue normal?

Pacemaker is working fine, and there are no underlying health issues....apart from my heart, obviously!

[Bellacheshire]

Hi Morningrise, I suffered from dizziness, fatigue and syncope and had a heart recorder fitted and several tests including the stress test as my heart rate was in the 40s.

Diagnosis followed of post exercise hypertension which is where my blood pressure drops after exercise and causes fatigue for days. Following research as I am a female aged 61 I changed to a high protein diet with carbs, veg and fat (nothing excluded) plus 2L of water daily. This has made a tremendous difference to my energy levels and reduced the fatigue dramatically. I am exercising and running with minimal fatigue for days afterwards. Hopethis helps

[Buddy00]

if you’re taking bisoprolol then this definitely causes fatigue. I have to really push myself at times to keep going. I refuse to sit there falling asleep.

[MPort in reply to Buddy00]

This is good well helpful to know. I started on it 10 days ago at 1.25mg and I drag myself around. I am so weary. Like you I would happily sleep. I am struggling through cardio rehab. I am 7 weeks post op. BP is acceptable and pulse rate coming down on Bisoprolol but... Mental and physical fatigue is a hard price to pay. I asked chatGbt for advice on forgetting things after heart op 😊. Now I carry a notepad around to note ideas before they evaporate.

[Qualipop in reply to MPort]

Bisopralol made me like a zombie. I could bare ly get out of the chair

[Morningrise in reply to Qualipop]

Hmm...sounds familiar! Even fun stuff becomes hard work.

[jacksonfan in reply to MPort]

What? Bisop is the cause of my extreme fatigue? I've been on a baby dose since 2014, never noticed fatigue, but increased to 0.75 recently because my EF is 22%. NOW my cardiac nurse has just increased it to 2 x 0.5. Sometimes I think the risk / reward is not worth it...

[Morningrise in reply to Buddy00]

Thanks! Bisoprolol seems to be a common issue. I'm in Scotland, and I've just discovered that it's possible to get access to a dedicated Cardiac nurse (through GP). I'll report back!

[july2020]

Hi

The trouble with being prescribed a suite of medications when you leave hospital is you can’t easily identify one that maybe causing you issues.

I can only suggest you work with your doctor or the practice pharmacist to work through your medication to see if that is the issue. For me it was the statin causing fatigue.

I hope you can find a way out from your situation.

[MPort in reply to july2020]

I had same problem. 3 medications. Atorvaststin clopidogrel and a PPI. And aspirin (for 15 years) after 4 weeks I was much worse than now. Aches dreadful, fatigue and brain fog. I decided it was statin. Came off for 2 days and started to become normal. So I agreed reluctantly to take Pravastatin 10mg but also Bisoprolol 1.25 this because pulse 100 ISH. Plus heart block. I am now a week on both. My head is clearer and I am ok when resting but am aware of struggle when exercising. I am doing cardio training. Today I did 10 mins warm up at about 85 pulse. No noticeable problem. Increased to 98 ISH IE up slope. Struggled a lot. I was fine when in cool down period. I am told I should begin to tolerate Bisoprolol soon. Hoping. I stopped PPIs weeks ago. My belief is if I eat the food recommendation for heart and fitness recovery and take a drug to lower stomach acid I won't digest it fully. This is just me opinion not recommending this. I take aspirin with breakfast and clopidogrel with food at lunch and hope they are sufficiently apart not to irritate the stomach. Both are coated. It's such hard work keeping track of medication symptoms. And don't start me on too frequent repeats from pharmacy.

[Nomis21]

Same here, 54 and struggling with fatigue and tiredness, after pace and ablate and having a upgrade to my two leads pacemaker to a 3 lead crt pacemaker after 2 years due to pacing induced heart failure.Currently on bisoprolol, dapagalozin, ramipril and was prescribed statins but had to come off them as they were causing bad muscle aches in my legs.

I struggle at work with fatigue, focus and tiredness.

I could sleep anytime, low energy levels and have to push myself to do anything.

Thought about early retirement but at 54 I'd need a lottery win! So I have no answers and not sure what the future holds for me, cardiology say there's no current heart problems so not sure if this is as good as it gets or what the future holds, just battle on I suppose.

[Rubia6 in reply to Nomis21]

On my I do know how you feel, you are a lot younger than I but, I more of less have the same problems. I have a 2 lead pacemaker but no longer take bisoprolol it just didn't agree with me I was in a constant fog and tired. I take dapagalozin the other one is new to me. Today I decided to try and improve my situation. I joined the local gym, will I manage it? I really don't know but I'm must try something. I have absolutely no energy nor the will now or had until today when I had a word with myself. I was diagnosed in 2021 with Heart failure LBBB and AF. I had a pacemaker fitted and an ablation. I was also diagnosed with lung cancer at the same time, I'm in remission now and it doesn't worry me at all. If I'm honest my heart problems don't either but frustration drives me up the wall. I'm so tired and feel so ill most of the time which is why I drastically joined the gym. Like you all tests come back normal, so that won't be going back to my GP. I'm hoping to have a gentle exercise build up and also to meet different people. Feel I have let my friends down due to the constant fatigue and having to cancel most of the time. Do hope you feel better soon.

[Nomis21 in reply to Rubia6]

Good for you, admire your determination, I do hope the gym helps.Can relate very much with the brain fog, fatigue, lack of concentration and lack of energy.

I'm not the same person after my surgery and often thought I need to buck my ideas up and make more of an effort.

I just feel things have taken it's toll, I still have a chest discomfort, thumping in my chest, palpitations and can't do what I used to physically, my body aches and I know things aren't normal but maybe that just how it's going to be and it's the new normal?

[MPort]

Very sad to read your post and the others above. I feel that too but I a have too high expectations after 8 weeks post surgery. Could that be your situation? Too high expectations? I hope you can resolve even parts of it.