Prednisolone and arrhythmia

[Andymurph]

I took an unfortunate "dive" down a staircase whilst trying to "Negotiate" the family golden retriever a couple of months ago. As you can imagine, being on both Prednisolone and warfarin things didn't end well as I ended up with wounds on both legs.

I suffer with lymphodema following PE's and both my legs ended up with the wounds ulcerating rather than healing.

Thinking if I reduced my prednisolone it might help with the healing I managed to taper from 15mg to 10mg. In doing so I didn't experience any pain breakthrough from my PMR but I did experience an onset of chronic fatigue ,breathlessness and the inability to walk further than about 50 metres without feeling the need to sit down.

I was referred to a specialist leg clinic this week and as part of my initial examination I was given a doppler test ( A type of ultrasound) to check blood flow from the heart to the legs. After the test was complete I was asked "Have you discussed your irregular heartbeat with your GP ?"

Seeing my surprise they told me Arrhythmia is known to be a side effect of prednisolone in some cases .

News to me. Has anyone else heard of this ?

[piglette]

I have problems with swollen legs and feet, lymphodema, which seems to have started when I started pred. I am on 5mg and the swelling in my feet has gone down a bit. If I get a bad bruise I develop a blister which can take ages to heal. I had a Doppler recently and the cuff caused a bruise and then along came another blister. I have spent the last year with district nurses and the surgery nurse dressing my legs.

Yes arrhythmia is supposed to be a side effect of pred or so I understand.

[DavidMF]

I've been on Pred. for 4 years and I'm reducing after my fourth flare and down to 7mgs. I'm on a blood thinking tablet Apixaban 5mg twice a day. Easy to bruise and slow to heal. I did have Atrial Fibrillation, i year ago, but since the blood thinner & Beater blocker, things are O.K.

You don't say how long you've had PMR, if it's less than two years you maybe expecting too much. Not aware that Pred can bring on Arrhythmia problems, so many other issues involved.

[PMRpro Ambassador]

Yes it is. But it is also a potential effect of the autoimmune part of PMR. I have atrial fibrillation - and it is definitely not due to the pred as it started long before I was given pred and soon after the other PMR symptoms appeared in my early 50s. The cardiologist is confident the a/i part of PMR damaged the electrical cells that govern heart rate.

Furthermore, in the spring I was reducing to 7mg and the a/f got worse after being well managed with medication. It was bad at 7, better at 8 and gone at 9mg. In the meantime I have developed a flare - now the a/f is fine at 15mg but returns after a few days at 14mg, sooner on 13mg. So - definitely not pred. And I'd wonder if you had less problems at the higher dose of pred.

What you probably DO need if you have an arrythmia is anticoagulant medication to reduce the risk of stroke/heart attack. I'm now on Pradaxa after a few years on a version of warfarin.

[Andymurph in reply to PMRpro]

Thanks for the reply - I'm taking 6mg of warfarin and my INR is usually in normal range.

By the way, hope your daughter enjoys her new job - My wife is an endoscopy sister and my daughter a nurse endoscopist. You can guess what the topic of conversation is in our house. lol

[Megams in reply to PMRpro]

~PMRpro - found your post interesting reading as always and great your Cardiologist is knowledgeable about PMR and its potential damage to the electrical cells of heart.

I must pose this question to the Cardiologist when he reviews the results of my 48 hour holter monitor next week.

I have been using White Willow Bark drops (salix alba) in the meantime to help keep my blood a bit thinner until we can find suitable med that will agree with my gut.

[Grants148]

I have had an irregular heartbeat at various times while taking steroids,it was worse when l had a PMR flare and fortunately settled down when l increased the dose.l am sorry that you hurt your legs so badly, the warfarin you are taking will cause more bleeding,but should be just what you need for your heart.l hope that your legs will heal very soon.

[mega]

I had it prior to the GCA which I've had for nearly seven years now. I also have retention of water in my legs and am on Warfarin and can't walk from the living room to the kitchen without being breathless and on the brink of keeling over( smallish flat) I think the nearest anyone has come to diagnosing it is vascultis and I am being treated for it. I have several other severe health problems too.

I am no expert but I would say your AF has nothing to do with your pred. medication.

Millions of people are diagnosed with AF, with or without a pred association and are monitored. Very few die from it.

I wish you well.

Mega