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    Old 12-24-2007, 01:44 PM   #1
    miranda262
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    Question How long for side effects?

    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

     
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    Old 12-26-2007, 06:31 PM   #2
    bobsmith2007
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    Re: How long for side effects?

    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

     
    Old 12-27-2007, 08:43 AM   #3
    huckfinn
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    Re: How long for side effects?

    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

     
    Old 12-27-2007, 09:17 AM   #4
    miranda262
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    Re: How long for side effects?

    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

    Last edited by miranda262; 12-27-2007 at 09:38 AM.

     
    Old 12-28-2007, 06:08 PM   #5
    huckfinn
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    Re: How long for side effects?

    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!

     
    Old 12-28-2007, 07:15 PM   #6
    miranda262
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    Re: How long for side effects?

    Hi Huckfinn,
    I also think it's symptoms of the defect and not side effects. I will definately address this with my cardiologist. These are the common...if I can use that word for this anomaly, symptoms. In my case, I had a stress test and ct scan which showed that I have no signs of compression of the RCA. So then
    why the symptoms....they just don't know.

    From what i've read if you live past 30, you have a very good chance of survival. I hope to put off surgery til i'm older. I was told that the artery,
    when moved can become weaker. I could be in for another surgery in 10-15 years. So i'm hoping to avoid it for awhile since i am 45 now.

    My blood pressure is always good, very close to 120/80 and the feeling i have in my chest is not pain. It's more of an annoying nervous feeling.

    I do have anxiety at times. It has been 1 year since it was found and I
    have fear of just dying suddenly. But, when I don't have symptoms, I'm much more positive. One thing is for sure, it has changed my life.

    I keep an medic id card in my wallet. I have monitored my BP and wear a watch to check my pulse when I'm exercising. They THINK that strenuous
    exercise triggers the ischemic attack, But they don't know for sure.

    A few weeks ago, i had terrible chest pains. I thought i might be having a heart attack. My husband was going in for back surgery the next day so I refused to go to the hospital. The pain lasted 3 days. If you don't mind answering this....what does a heart attack feel like? How do you know if it's not a strain or a gas pain. I'm going to ask my cardio to explain that to me also.

    Regards,
    Miranda

    Last edited by miranda262; 12-28-2007 at 07:18 PM.

     
    Old 12-29-2007, 12:49 PM   #7
    huckfinn
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    Re: How long for side effects?

    Hi Miranda

    Whew, I have been studying your condition again a lot this morning. All I find mainly is a description of the anomalies, and surgical means of repair. Also most of you pass stress and other tests. The condition is treated with beta blockers for a few reasons, but I really searched for the use of CCBs, as the medical literature says the mid portion of your RCA is more subject to spasms than a normal originating RCA.

    Spasms could be causing these nervous type feelings in your chest. Coronary artery spasms can also cause a heart attack if the spasm continues long enough, and blocks blood flow to the myocardium long enough. They obviously can also cause angina. Lets call a heart attack an MI or myocardial infarction, lol. Heart attack is scary to me

    You should always carry fast acting nitroglycerine, either in tablet or spray form. As you know this drug dilates the arteries immediately and can save your life. They can also stop angina pain fairly quickly. It would be good for you to experiment with nitro when you have pain or the strange feeling in your chest. I would talk to your doctor about this. Nitro can lower your BP instantly, but unless one has hypotension there really is no need to worry, I have read.

    You also need to carry aspirin with you. The AHA and AMA both recommend chewing two adult aspirin if you think that you are having an MI. The reason I keep referring to an MI is because your condition, as you know, can cause one. So please be prepared at all times. I keep my fast acting nitro in my pocket at all times. I have the spray and pills.

    As far as how an MI feels, well it is a fact now that many women have different symptoms than men. Women often have a vague feeling of being ill, nausea, pain in their shoulder, jaw or neck. I had what is often called the classic Hollywood style of an MI. I had just laid down for the night, after an off day of being pretty active. It hit me like a train. I knew immediately what it was. The pain was radiating straight from my heart. It was a very, very powerful dull burning and aching that I had never felt before. I knew it wasn't heart burn. It radiated up into my right jaw, went across my jaw and down into my left shoulder and down my left arm. The pain in my chest would get really bad then just bad, in cycles and taking my breath. The pain was very dynamic, not steady. Then the emotional part comes to play. I realized that I was dying. This feeling of doom like I had never felt came over me, and it seemed like I looked death straight into the eyes. There was some flash of an entity. I do not know how long this lasted. I think for about 10-15 minutes, then I had a stroke an went unconscious.

    I had woke my wife who was in a deep sleep, to tell her goodbye when the pain started, but she said you are just having bad gas, lol. I was moaning and writhing in the bed so she woke up and found me unconscious, then called 911. The doctors suspected that I had a plaque rupture that totally occluded my Ramus artery, causing the MI, which pumped a small clot that blocked a tiny artery going to a deep part within my brain.

    Sorry for the drama....but it was a life changing experience as you had when you found out about your RCA origin.

    One more thing; I have had a lot of cardiologists and they all have handled my refills for the anti-GERD or proton pump inhibitors like Nexium. They do NOT want me to mistake heart burn for angina. That has lead to many deaths. I think I have stated on this forum before that my grandfather and many other people have been found dead from an MI, and they were clutching Rolaids or Tums.

    I will stop preaching and rambling

     
    Old 01-19-2008, 01:29 PM   #8
    miranda262
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    Re: How long for side effects?

    After seeing my cardiologist, instead of changing my Med again, he had me go for a stress test. The good news is I did very well on it, so I can pretty much do whatever exercise I want, with the exception of using weights.

    I still had the side effects, loss of breath, anxiety, so now I am on a different
    med called Cardizem. Maybe I will do better on channel blockers instead of beta blockers (already tried 4 of them).

    I started Cardizem last night and I cannot believe how much more anxiety I feel. I don't know if it's just me or it's the medication doing it to me. I do
    not see this as a side effect. I hope this passes. I have never had anxiety like this. Any thoughts or comments on this drug would be appreciated. Also
    beta blockers vs. channel blockers...what is the dif.

    Thank you.

    Miranda

     
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