How long for side effects?

[miranda262]

Hello,
I haven't posted here in awhile, but i'm looking for some feedback on beta-blocker side effects.

I am on my 4th beta blocker, sectral, in the past year. (1 year ago i was diagnosed with anomalous origin of the rca, it's a defect)

My first was metoprolol, 2nd coreg, 3rd atenelol. I was doing well on the atenolol til about month 3. Then I was put on acebutolol (sectral) and was
doing great for the past 3-4 months. Now i'm starting to get the same feeling as on the others. Fluttering, shortness of breath, lightheadedness. The fluttering thing is hard to explain because it's sort of
like a pang of anxiety. Comes out of nowhere and last only a few seconds.
I've considered that's exactly what it is, anxiety, but I really don't think it is.

I'm starting to wonder if it's possible that it's not the meds since i'm fine for months at a time. I was really hoping this was it as far as changing meds. Every time I start a new one, there's the adjustment period, being really tired and gaining more weight.

Anyway, I was wondering if there are any opinions as to side effects taking so long to start? And, why the same exact side effects on all of them.
Possibly if I wait it out, they will pass?
I'm so bummed......Any thoughts would be appreciated.

Thank you...Miranda

[bobsmith2007]

Hey Miranda.

Anyway, I was wondering if there are any opinions as to side effects taking so long to start?
Side effects come on at different times in different people, although can usually be soon after starting to take - but again, varies in different people.

And, why the same exact side effects on all of them.
As beta-blockers generally are working on the same system/mechanism of action, it's likely that they will give similar side effects (if one was to).

Possibly if I wait it out, they will pass?
Possibly - depends how you feel about it/can tolerate them.

I'm so bummed......Any thoughts would be appreciated.
If you're worried, how about going to see your doctor - could a different class of drug be used (i.e. not a beta-blocker) if you don't seem to respond well to them.

Best wishes

[huckfinn]

Hi Miranda

I also have a bad RCA. It is "congenitally small and insignificant" as stated in one cath report.

My question is why were you originally prescribed beta blockers for your anomalous origin of your RCA? Do you have symptoms from your RCA origin?

I have taken BBs for 6.5 years. I have tachycardia (pathological rapid heart rate) and high BP. I took atenolol (an older generation BB) for 6 years and really suffered from fatigue, but was told and read that all BBs cause this. Well about 6 months ago, I got really sick and my cardiologist thought that I had developed drug induced Lupus from atenolol. (atenolol is on the list of drugs that can do this).

I changed to the BB most recommended for heart failure, Coreg, (which I do have diastolic dysfunction, and possibly Diastolic Heart Failure). Coreg is a newer generation of BB and it has less of the fatigue side effect, to me. It also is "good for" the arteries. It does however have a reputation for making people dizzy for the first month or so. You have to be very careful. I still stagger a bit, lol.

I understand why BBs cause fatigue, depression, weight gain and other side effects such as an increase in blood glucose (a bit). BBs also cause reduced blood circulation, especially in the extremities, and can cause exercise intolerance. These side effects are not experienced by everyone that take them, but many do.

It is because of what BBs were "built" to do. They take a load off of the heart by decreasing the heart rate, and by decreasing the force of the contraction of the heart muscle (beat). This lowers heart rate and BP. I had a heart attack and stroke in 2003 and will have to take some type of BB for the rest of my life. I don't plan to run any races though, lol.

Did you know that doctors (non-cardiologist) prescribe BBs to people for stage fright? If you have ever done any public speaking, you may remember how the heart can start racing, which can cascade into an anxiety attack. BBs prevent the racing heart, and possibly an anxiety attack.

I think Bob had a great idea; can you try another drug?

Remember that almost everyone that takes a large enough dose of any beta blocker will have side effects. Some BBs "fit" better than others. They are not the most popular medicine, but people like myself know that we need them to survive. I was always too afraid to try another type because of an incident I had when I stopped atenolol abruptly. The following 9 days were he**, and the heart attack and stroke (simultaneous) happened about 6 weeks later. I only stopped them for 4 or 5 days but my BP and heart rate was unimaginable even after I started it back for awhile.

Remember to never abruptly stop a beta blocker that your body has become accustomed to. It can cause the sympathetic nervous system to go hay-wire. Your BP and heart rate can swing wildly and cause a heart attack and/or stroke. You must slowly wean off the BBs under the direction of a doctor. (broken record here )

Happy New Year

[miranda262]

Bobsmith,
Thank you for your response. I do have an appt with the cardio middle of January. Usually when the side effects start, I rush there to see him, but
I think I will wait a bit this time.

I had a thought about the side effects. Maybe they are not side effects at
all, maybe I've built up a tolerence to the BB. The side effects on these
drugs are the same as my symptoms before I went on them. I'm going to ask him about that before I just go onto the next drug.

Huckfinn,

Thank you also. The reason I was prescribed the BB is because my anomalous RCA originates from the left coronary sinus and travels up inbetween the PA and the aorta. This can cause ischemia (usually on heavy
physical exercian, they THINK) which is usually fatal, when the blood pressure rises too high and the RCA is compressed. As explained to me,
the idea of the BB is that maybe an ischemic attack won't be fatal if it does happen. Again, this is the theory. It's very frustrating to get a bunch of "we thinks" from the Dr.s They are just now starting to find this anomaly, usually in less than .1% of the population, with the new 64 slice ct scan. In the past it was mostly found on autopsy's. Usually athletes that have died suddenly while doing their sport.

The symtoms that led me to find this were dizziness, being lightheaded all the time, off balance and almost passing out, mostly when I tried to go to sleep.
So, the symptoms are not that much different the the BB side effects. From all the case studies i've read, and that's ALL you really find on this, these are the same symptoms others have experienced.

I did not do well on Coreg, Atenalol worked for me for 3 months before I started having problems and I have felt the best on Sectral (acebutolol) until now. For all of them there is the initial 2 weeks of feeling lousy and gaining more weight. WHich is why I don't want to stop it.

What I'm feeling is hard to describe. It's sort of like the expression "My heart sank" but that's what it's like. It's like what you feel when you realize you've
made a terrible mistake,that feeling in your chest. I don't know how else to describe it, but it comes and goes all day now. And when out shopping the lightheadedness is back, and the passing out feeling is starting.

All I want is to get past these problems and live my life, and maybe not think
about this for a period of time. I've been on many heart messageboards over the past year and have not found anyone with this problem yet. I'll be on medication for the rest of my life unless I have the surgery, which I do not want. (bypass or relocation of the rca)

Thank you both again for taking the time.

Miranda

[huckfinn]

Hi Miranda

I read up on your condition the other day and now I realize how serious it could be. I kept trying to find where it was treated with a medicine other than beta blockers, such as calcium channel blockers which are the first med prescribed for coronary artery spasms, I think.

Anyway, it seems that your condition should also be treated with vasodilator, such as nitroglycerine especially when you have this sinking feeling in your chest. I think this feeling may be angina which is caused by ischemia, as I am sure you know. Lack of blood flow to the muscles of the heart, through the coronary arteries is called ischemia and the resultant pain is angina. I have/had loads of angina and ischemia due to CAD. I am looking at bypass surgery soon. I have probably already mentioned that in this thread. It is dominating my thoughts these days, so I can really empathize and sympathize with you about having the surgery.

I am 55 and know that I could have a massive heart attack anytime, yet I feel that you are much younger and should not have to worry about SCD or a heart attack. Especially because of a birth defect. I don't see how you live a normal life knowing what you know. You are a very brave person I surely don't live a normal life. I am retired. I would not worry about heart disease if it were not for angina and 0 energy.

I was hoping that you wear a medic alert bracelet describing your birth defect. There are places on the net where you can buy the bracelets, then have your own description inscribed on them.

I am sure that since your condition is so rare, it is hard to find an expert cardiologist to treat you. I highly recommend the Cleveland Clinic.

I wanted to mention to you that there is what is known as a feeling of doom that is experienced by many people while they are having a heart attack. It is really hard to describe but is really bad. The reason I brought this up is because I was not sure if the feeling in your chest was totally physical or part emotional or psychological. A bad attack of angina causes me to remember my HA, but if I had never had an HA, I think it would bring on a very fearful reaction.

As far as surgery, I hope that you make the right decision.

I hope that I have not bugged you.

Happy New Year

P.S. When I first started beta blockers years ago, the cardiologist gave me a log or journal to record my heart rate and BP every 2 hours. This was to determine the optimum BB dosage. I never hear anyone talk about this nowadays. Have you ever done this?

If you would try it, and get your BP and heart rate as low as possible w/o being dangerous, these symptoms might go away. I really don't think these symptoms you are having are side effects of BBs. I think they are intermittent occurrences of the symptoms of your condition, but what do I know? Not a lot Keep your chin up. Oh yeah! Maintain perfect posture!