Besremi and the heart

[Ovidess]

I restarted a moderate and steady 100mcg dose of Besremi this fall, after being off it all summer. (Most recent test showed my platelets continuing down but HCT and liver enzymes a bit up.) The day after my last shot I had a strange episode while cooking dinner. For 5 or 10 minutes I felt a pounding, fluid beat in the middle of my chest (aorta??), like a slippery thing turning over rhythmically. Very creepy. I had to sit down and not talk until I breathed it into submission. I immediately called my hema/oncology team. We talked about the possibility of stress inducing it (yeah, more than one health issue in my household right now), but it was so unfamiliar to me that I was worried. I did not "come to" PV with any heart/BP issues. A heart ultrasound and all other work ups related to Besremi risks (initial doctor, pro HU, was very leery of Besremi) all came out very well this last year. Nurse told me to go to emergency if it happens again, of course. They did note how close the reaction was to my injection.

Has anyone else had possible heart related incidents while on an interferon?

[Dane12]

Hi, Yes, I developed an arrhythmia a year after starting Besremi (premature ventricular contractions). After consulting quite a few cardiologists and electrophysiologysts (with all possible investigations - echo, stress effort EKG, angioCT, cardio RMN), none of them could confirm that is related to Besremi or due to a stressful event I experienced right before the arrhythmia showed up. Anyhow, all of them said that I should not interrupt the Besremi treatment as the type of arrhythmia I developed it is not a risky one ( it can be kept easily under control ) and the benefits from treatment with Besremi supersedes the eventual side effect. To be seen ...

[Ovidess in reply to Dane12]

Thanks, Dane12, I hope your docs are proven absolutely correct down the line.

Can you tell me what the arryythmia felt like (if you don't mind doing so.)? Do you still sense it or do they give medicines to control it?

[Dane12 in reply to Ovidess]

Initially it was asymptomatic (caught in a routine EKG). After that, I felt it like a flutter (weird feeling when you experience it first time). I am taking a beta-blocker (bisoprolol fumarate - Concor) 2.5 mg once a day. This reduced considerably the number of PVCs.In top, I was given Mg and Potassium supplements. Hopefully this helps.

[Anag in reply to Dane12]

your heart symptom does sound creepy, especially the slippery part. Do keep an eye on that, but don’t worry. Remain objective

I developed heart problems from Anagrelide. If you’re masking the problems with other drugs, it’ll continue to get worse without you realizing. I was masking the anagrelide symptoms and I went from a stage 1 mitral valve problem to 1,5 in 2 years. There was a day that my heart was pounding out of my chest for 70 minutes!! The emergency doctor who came to my home said it’s a panic attack it I had strength, I’d have kicked him into waking up . Panic attacks do not usually last more than 15 minutes and I was completely calm just fighting for air to feed my heart’s need for more oxygen, which as a chronic anaemia since birth, is tough

My new doctor MPN specialist and I stopped, anagrelide, went to Besremi. And things were fine till 4 months ago, where body pain has started getting out of control. Heart has been fine.

It’s important to keep the body’s chemistry balanced. Every single medication that we take causes deficiencies. Please look at your medications and search up which deficiencies they cars and then supplement them!!

[Dane12 in reply to Anag]

Thank you for your suggestions 😊!

[Pogm]

Hi,

I have a history of atrial fibrillation which was corrected by a cardiac ablation performed in 2007. I too, am on Besremi(50mcg) and it was reduced from 100mcg because I developed very high BP and severe headaches. I currently take Dilitizam, which controls my heart rate and BP. I have not experienced any heart irregularities since being on Besremi but it is a good idea to consult with a cardio-oncologist. They specialize in treating co-morbidities and are trained about medications such as Besremi. My 1st visit will be this coming Jan 2024. It sounds like you may have had atrial flutter( had that in the past, before Besremi), which is benign the majority of the time and resolves on it's own. Otherwise, reduce your stress as well as you can and do your best to find a cardio-oncologist in your area. It may be a relatively new field, so reach out to your hematologist in helping to find one. Good luck and hoping for all of us that Besremi continues to be our "drug of choice"!

[Ovidess in reply to Pogm]

Thanks, Pogm. Great info for me. May you be well!

[PhysAssist]

Hi Ovidess,

The best information is that you were worked up prior to all of this and came out with a clean bill of health.

The kind of sensation you felt could have been from any of a number of rhythm disturbances, but as long as they are no recurring and especially if they don't worsen with activity/exertion, they are extremely likely to be benign.

That said, breathing through it and then calling your care team was the right thing to do,

Continue to follow their direction, and above, try not to over-think or worry about it.

Below there are some articles about this topic from reliable sources of medical information.

Best,

PA

bhf.org.uk/informationsuppo....

uihc.org/health-topics/hear....

mayoclinic.org/diseases-con...

[Ovidess in reply to PhysAssist]

Those were very helpful articles, PhysAssist, thanks! I appreciate your help.