Erratic heart caused by adrenals?

[Nagswoman]

Hi all. Odd one. I got put on bisoprolol, small dose, Feb 2018 as I was getting erratic heart beats. No probs since until 3 weeks ago. Doc doubled bisop. No change. Got sick of sleepless nights. Been on preds over 5 years now. Up and down. 2.5mg since March 1st. Felt useless. Getting worse. Pain not too bad. Crp and esr both only 13. Waiting for a 24 hr heart monitor. 3 days ago bit the bullet and upped preds again to 7.5. Erratics gone. Could this be adrenal gland related? Rheumo appt in 4 weeks just got cancelled. Not seen one now since 30th dec 2019. Other cancellations. Very short phone calls twice instead. New doc questioned gca diagnosis.

[Nagswoman]

Just saw that I posted a similar thing over 3 years ago.

[Kendrew]

Hi Nagswoman. I can't really explain what's going on with your erratic heartbeats but I had a history of the same prior to PMR diagnosis. Having been free of them for a good few years, not long after I was put on pred, they reoccurred and progressively became more frequent and more troublesome. Bisoprolol didn't seem to help so I was referred back to cardiologist (privately) who fitted me with a tiny ECG monitor that simply stuck to my chest and recorded every heartbeat, flutter, missed beat etc, for 2wks! As previously, the sensations I felt were found to be ectopic beats..... uncomfortable but harmless. I was put on propanolol 80mg daily and now down to 40mg daily with no further issues. I'm currently on 8mg pred but during the problematic period, I was on a dose of 7.5mg down to 2.5mg so may well have been adrenal related!! I'm not an expert though so you'd need to discuss that with someone who is....or wait for the more knowledgeable people on here to comment and advise.

Wishing you all the best.

[piglette]

I had a Holter test for heart monitor check, it checks your heart beat, but mine was for 48 hours for some unknown reason. (I had an Echocardiogram too). Really annoying as I was not able to shower for two days. Also had to take the equipment back for return exactly 48 hours after it was fitted. I am not sure how important that really is. The hospital was twenty five miles away and it decided to snow quite badly just before it was supposed to be delivered. Luckily some kind neighbours delivered it for me. I must admit I did forget about the monitor most of the time and went round unwashed!!

[PMRpro Ambassador]

I have an arrythmia - cardiologist sure it was caused by the autoimmune part of PMR and it is markedly worse during a flare so more pred is helpful and part of the reason I'm on the dose I am (15mg). I am also on a relatively high dose of an antiarrythmic, bisoprolol alone isn't enough at a dose I can function well at.

The combination with adrenal insufficiency - which at this dose and time on pred is very likely - is known to be associated with arrythmia. One form is due to what is called prolonged QT syndrome and would manifest if you were under stress of any sort.

Is that a GP or a rheumy casting doubts on the GCA diagnosis? Having never seen you at the time ...

[Nagswoman in reply to PMRpro]

GP. Thanks PMRPro. Says it all really. I have not had arrhythmia for 3 days now and I slept right through last night. Awaiting a discussion and a telling off. Funny how people with these sorts of things have a gut feel as to what will work. Over the years I have been threatened with an endochronologist, a synacthen test, told that I will probably be on steroids for life, told to get off the steroids, usually by 1mg a month...I wish that there was a central PMR, GCA etc, clinic, full of experts. I would be happy to travel a couple of times a year. I get far more from PMRGCAUK than the NHS.

[PMRpro Ambassador in reply to Nagswoman]

Well we live it don't we? And have the combined experience of thousands of patients to draw on so we see commonalities ...