My mother has been on topral for over five years. A year ago ago she had surgical ablation for atrial fib and and a pacemaker implanted. Started on coumadin also a year ago. The past year she has become increasingly short of breath. If she's up for awhile she can breathe better but to stand up, bend over or start energetically walking causes her to have chest pain and extreme shortness of breath. She just recently had an echocardiogram and chemically induced stress test and heart is strong. We are wondering if the Topral could be causing the shortness of breath. Any help is sincerely appreciated.