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Old 12-20-2007, 11:34 AM   #1
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Heart Scare?? Don't know what to think!

Hi all. I had a weird occurance last week and after being worked up once more by the cardiologist, I am at a loss. Two weeks ago I had an epidural for Fibro related problems. I also started a new heart med Pro_cardia last Wednesday. I felt a little uneasy and antsy on Wednesday but took the dose again on Thursday Am. By that afternoon, my BP was running in the 150/90s and pulse in 120s. I was feeling a booming heart beat in my head and my chest and felt as if I was going to jump out of my skin. I was so miserable I dare not drive. I called the Cardiologist Friday and they suggested I go to a local ER for a strip, but as I have no one to drive me, and I was not going to call the ambulance, as I was convinced it was med related reaction, I delayed until the first of the week.

Well by Sunday I felt well enough to drive to my doctors' area some 60 miles away and I saw the Cardiologist on Monday morning and they ran a strip and ordered a 24 hour holter monitor and a Carotid study which I completed on Tuesday. I have already heard that the studies were fine. But the cardiologist seemed to blame the *******ia or he stated I just "developed" hypertension. My BP was 167/86 in his office and pulse in high 90's. I have always had extremely low BP and the cardiologist was reluctant to initially give any med that may knock my BP down any.

Well today I go to see my Pain Med doctor and he seemed to think the culprit was the steroid from the epidural some week earlier. I am not convinced since the cardiologist seemed to shrug off that probability. I have now started medication # 4 to try, Atacand_ and I do hope this one does the trick. The cardiologist is adamant to get me on some med due to the multiple valve regurg I have developed. I must say day 2 is going well on this med. Your thoughts?

 
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Old 12-22-2007, 11:00 AM   #2
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Re: Heart Scare?? Don't know what to think!

Hi Goldy

So sorry to hear about your very scary episode. I started doing some studying up on your event yesterday. I am so slow.

As far as the high BP and heart rate, after taking *******ia, I could not find a direct link as far as an adverse effect. What I did find was, well I ended up on a proclampsia forum in a thread where 4 or 5 women had the same reaction as you, rapid heart rate (tachycardia) of up to maybe 120 bpm. The trouble is, they did not check their BP! But all things being equal, such as a left ventricle ejection fraction (LVEF or EF)>50, normal kidneys and liver, the increase in BP should have followed the increase in heart rate, as I understand it, ie their BP would have been high also. These women kept taking the medicine for a couple of days and the tachycardia went away.

I did find that this is a very common medicine for people with aortic valve regurgitation, and high blood pressure.

One thing that I couldn't find in your post was why your cardiologist wanted you on a BP medication, i.e. was your BP trending higher? I do know that your cardiologist wants your BP as low as absolutely possible, AND wants you on a medicine that can both lower your BP and help prevent your heart from remodeling. Certain calcium channel blockers (CCB = *******ia) and an angiotension receptor blockers (ARB = Atacand) can do this. I am taking Norvasc now for diastolic dysfunction and BP control along with many other heart meds. The Norvasc and an ACE inhibitor altace are specifically for trying to restore my diastolic function, along with BP control.

The ARBs do the same as the ACEi's (angiotension converting enzyme) except in a different way the ARBs are a much newer class of drugs. Angiotension is produced by the body and constricts the arteries when we are ready to fight of take flight, lol.

What you need to be aware of is that one of the symptoms of aortic regurgitation is palpatations or arrhythmias, which could include tachycardia. That may be why your cardiologist told you to go to the ER. This could have been treated with a beta blocker. Your cardio probably also knew that the *******ia could have been the culprit, as you suggested.

There is chronic aortic valve regurgitation and acute aortic valve regurgitation. The medical literature reads as if one has one or the other, which I doubt is the case. Anyway, acute AR is a medical emergency because of an extremely rapid heart rate. It seems to me that some one with chronic AR could develop acute AR, but I think you need to ask your doctor about this. I think you may need a medical alert bracelet describing your condition and you need to call an ambulance if your heart beat and BP go high.

Did you know that autoimmune diseases, including lupus, rheumatoid arthritis, scleroderma, and Sjögren's syndrome can cause aortic valve regurgitation?

I also read that Ankylosing spondylitis could also cause aortic valve regurgitation.

Once again here are the symptoms of AVR:

Fatigue or weakness.

Shortness of breath, especially with increased activity.

Abnormal heart rhythms (arrhythmias).

Palpitations, an uncomfortable awareness of the heart beating rapidly or irregularly.

Angina, chest pain often brought on by exertion.

Fainting (syncope).

***In acute aortic valve regurgitation, the above symptoms develop suddenly and are often more intense. People with acute aortic valve regurgitation also may have a fast heartbeat (tachycardia). Acute aortic valve regurgitation is life-threatening and requires immediate medical attention.

Do you know what your ejection fraction is?

 
Old 12-23-2007, 06:01 AM   #3
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Re: Heart Scare?? Don't know what to think!

Hi Huck, yes it was a scary incident. I am so wary of taking meds now as I have had some very unusual reactions and to tell you the truth, the heart meds really intimidate me. Last echo showed an EF of 55-60% and had not changed from the previous one some 6 months earlier.

My pain medicine doctor who manages the fibro for me, seemed convinced that it was a reaction to the steroid a week earlier. I imagined you would have a reaction more immediate than what I witnessed, but I know as with all sciences, medication can cause varied responses in individuals. The fact that it was an epi and that it involved the spinal cord tends to make me feel that a reaction would be more immediate than what I witnessed, but as the PM doctor wanted to delay a lumbar block, I guess he knows what he is talking about! I have had the best of results from the last epi and I sure hope this episode does not remove any future steroid epis from my care plan. This is the first time in years that I have not had constant burning, stinging, aching in my neck, shoulders and arm. I better enjoy it while I can.

Tis funny that you mentioned the auto-immune disease, Sjogren's. My older sister just tested positive for that and I have a referral to see yet another Rheumatologist (will be my third) as I am a challenge to treat because of all my ailments and intolerance of a host of meds. I was told a fresh pair of eyes may see something that has been overlooked or just a fresh idea in how to treat. I am anxious to see if there may be some auto-immune culprit that has caused this cascade of events to unfold in me. I really believe I may have lupus based on all the literature and my symptoms. This particular Rheumatologist tends to look for a viral, or biological cause and not just the diagnostic criteria to treat his patients, so I will be interested to see what may be in my background that has caused this malady and the heart problems as well.

Well I am on week 2 now on the Atacand and all seems to be going well. I am not checking the BP as I did with the Pro_cardia, but I can tell by my behavior that it is not doing what the other meds have done. I feel ok, not washed out, etc.

Well I am off to the drugstore as soon as they open as I have acquired my Holiday sniffles already and I need to get a med that will mix with the Atacand. I guess my Nyquil is out of the question now. Peace to you and hope you have a nice holiday.

 
Old 12-23-2007, 09:00 AM   #4
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Re: Heart Scare?? Don't know what to think!

Goldy... I have fibro too. I just had 6 shots in my low back, but this time they didn't work. Anyway... my pm doc says they're very careful on the dose they give as to not cause any problems. But... it's possible to become anemic because of the steroids. I did.

Good luck,
Mary

PS... please remember everyone to take an active part with your heart problems. Have an advocate if you can... someone to help you remember questions and answers.

 
Old 12-23-2007, 02:20 PM   #5
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Re: Heart Scare?? Don't know what to think!

Thanks Mary for the well wishes. I am sorry you have the fibro to deal with as well. It definitely is not fun to deal with. I am a strong advocate, having had Nursing studies and clinicals, I know that the best advocate is the patient themselves. I try to read all I can and go armed with questions. I do see a trend in doctors feeling somewhat intimidated by a patient who knows a little about their disorders and at times, I may come across too strong, but it is my body and my disease and I don't intend to change my eagerness to contribute to my care.

It is not always possibly to have an advocate with you other than yourself. I have been widowed a long time now and it is almost impossible to have someone with me at every single appointment. It can be a barrier at times as I have had one physician deny that he gave me certain instructions, which I was happy to have had an advocate on those days.

We fight for every bit of care we get. I know that I leave an office far too often not having had my "full opportunity" to have my say. I may be viewed as one who suggests way too much or offers way too much info at times, but I see a total of 9 different doctors and I think it is very important to have everyone on the same page with each other. I seem to spend most of my visit catching up the present doctor with what has gone on since I last saw them. I truly believe that the body has to be treated as a whole. You cannot treat one thing without it affecting another. I honestly wish each one of my doctors would share info with the others on a routine basis. I think it would make my care plan a little easier.

 
Old 12-24-2007, 08:42 AM   #6
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Re: Heart Scare?? Don't know what to think!

Well Goldy, sorry about those sniffles, but glad to hear about the Atacand

Yes the autoimmune diseases sound very suspicious in your case. Don't lose sight of the forest for the trees though...Meaning watch your heart! I have been diagnosed with osteoarthritis, FM and CFS but I only pay attention to the arthritis along with my heart disease. The feeling you describe in your neck, shoulders and arm is exactly the pain I have in my lower spine. I take tramadol for the pain and it is a life saver.

I am really glad you have found relief with the epidural. My rheumo, whom I stopped seeing, gave me lower back trigger point injections which began to do nothing for the pain. I only see my cardiologist now, and a PA at a little rural clinic up the road from me. My family doc comes there once a week. It is just too hard to get to Huntsville from western Limestone County these days. I just do not have the energy to get ready and drive. I am convinced that the lack of energy is due to my various heart problems. I have forgot about FM and CFS, except every now and then I think of Dr. Paul Cheney's theory about CFS or FM and heart disease. Still the bottom line is I have heart disease.

I am hoping to make it through the holidays without having bypass surgery. HEY! Speaking of meds, I have never been able to tolerate statins, and I have tried them all, but I started Lipitor about 1.5 months ago at 20 mg per day. I break a 40 mg in half, and have been tolerating it!!! This could be a life saver for me.

I have an inherited condition called hyperlipidemia that causes my cholesterol and triglycerides to be extremely high. I had the "lethal" reactions to the statins. 8 years ago, My TC was 487 and tri's were >2000. The first Lipitor was old samples.....but I got my cardio to prescribe Lipitor for me. I believe I can tell the difference in strength, but I am going to continue taking it. It might keep these 6 stents from stopping up.

Well, get over those sniffles, start taking your BP at once, and have a Very Merry Christmas

Huckfinn

 
Old 12-24-2007, 05:53 PM   #7
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Re: Heart Scare?? Don't know what to think!

Hi Huck,

Sorry you have the FM and CFS too. Who is Dr. Cheney and what is his take on all of it?

 
Old 12-27-2007, 12:07 PM   #8
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Re: Heart Scare?? Don't know what to think!

Hello Huck, Hope you made it through the Holidays unscathed. I had my yearly bout of bronchitis and got a little dent in my car for Xmas, not my doing, but other than that I have made it fine, especially on the Atacand. I refuse to take my BP or obsess about this med. I am just going to stick it out. Actually I don't even know I am taking it. Isn't that wonderful?

I also have hyperlipidemia. Highest mine got was 367 before they finally got me on Simvastatin. I am the only sibling out of 5 that has inherited, and pardon my bragging, but I am the only skinny one of the bunch, but I get the cholesterol problem. Go figure. My late husband battled ulcers all his life, so I have never been one to eat fried or fatty foods, so I know mine has to be the inherited type also.

Well I am happy to hear you have dodged surgery at this time. I have a script for Tramadol and am to pick up a TENS unit tomorrow, for home use. I find that Tramadol does help at times. I think that an extra Flexaril and a Tramadol seems to help more than anything and since I am drug resistant in a lot of ways, I do not wish to add anything stronger but use heat, Tens, topicals, and injections as long as possible.

Yes , please expand on Dr Cheney's info, I would be interested in anyone's take on the probability that the valve disease may be fibro related.

 
Old 12-28-2007, 02:26 PM   #9
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Re: Heart Scare?? Don't know what to think!

Well, I read up on Dr. Cheney's theories/beliefs. They only pertain to Chronic Fatigue Syndrome (CFS). Are you guys still interested? If so I will do a little report when I get the time and energy

Basically he believes that everyone with CFS has Idiopathic Cardiomyopathy and low cardiac output, proportional to the seriousness or degree of their CFS, but he doesn't believe that everyone with ICM has CFS. He had ICM and received a heart transplant. He does not have CFS.

 
Old 12-28-2007, 07:00 PM   #10
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Re: Heart Scare?? Don't know what to think!

Yes Huck, amuse yourself with educating this one. I for one, believe that I also have CFIDS as I have had longtime occurance of sore throat and swollen lymph nodes regularly and I have episodic exertional malaise as well as just no energy. I used to be this person who could work circles around kids half my age but those days are long gone now. I feel once I see this third specialist I may see the combo diagnosis.

I have seen in my own research the theory that FMS is considered a connective tissue disorder and that particular report showed a connection between FMS and heart valve damage. I know that it took me about 4 years to get someone in a white coat to take me seriously enough to get the fibro diagnosis. I was told by the 1st Rheumie, it mattered not what I had if they were unable to treat me successfully. I tend to disagree, I think one needs to arm themselves with as much info as possible. How can one be an advocate for their own care if they are ignorant of their condition?


I await your findings on the subject.

 
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