Heart Meds and Side Effects

Heart health and blood vessels
1

Hello forum.

Keen to get some views...

Heart attack May 2015 (out of the blue). Single stent fitted in a great hurry to fix blockage of 1 small section of coronary artery, rest of coronary arteries in ok shape for a 45yo male, but echocardiogram after heart attack showed low ejection fraction (30%-35%) - result of damage to heart tissue. I was extremely weak.

Recovered strength quickly. Could barely walk when I left hospital, but within 6 weeks I was able to walk 20 miles, go on bike rides, etc. Have gone on walking holidays this year, climbed Snowdon, etc. - no particular problems. BP, pulse, O2 sats, etc. all ok (BP a bit low in the morning, 100/60 ish, tends to climb during the day to around 120/70). No pains, no breathlessness.

Quite aggressively medicated due to poor echocardiogram result and young age ("you're strong, you can take it"wink. Currently taking:

* 75mg aspirin

* 10mg ramipril

* 80mg atorvastatin

* 10mg bisoprolol

* 25mg eplerenone

Echocardiogram a few months later showed a decent improvement - ejection fraction around 45% - still less than ideal.

Having problems with a lot of pains in my neck, also sometimes in my shoulders, upper back and fingers. GP says no sign of anything serious (no reason to think it's angina, for example) but seems unsure of what the cause might be.

Also problems with "feeling out of it" - a dazed feeling, difficulty concentrating, etc.

Does anyone with any experience of these meds know if there's any one of them that might be causing all of this? Obviously any discussions on here are no substitute for advice from my GP, but it can take 3 weeks to get an appointment to see him! (grrrr)

Severely affecting my quality of life at the moment. I really need to do something.

Thanks!

Alan.

2

Alan I ain't no doctor but like you had a heart attack out of the blue 3 years ago. I think you are over medicated no wonder you feel out of it. Your heart attack was over a year ago so if I was you I would be seeking to reduce the following meds.

10mg bisoprolol is a killer does for most people. Ask if you can gradually reduce it. There will be withdrawl symptoms resulting from this. 80mg of Statin is another large dose.  If you Colesterol is too low ask to reduce this. You need a certain amount of  Colesterol too low will make you feel ill. Ramipril is another cheap nasty drug that lowers your BP but alot of people cant take it. If you are able to do all the things you say in your post I cannot see why you need all these meds and at such doses. 3 of you meds are to reduce your BP so no wonder its low in the morning I think you will have a hard time coming off / reducing them. Has your doc said you have heart failure 45% is boarderline and this may be why you are on such an agressive drug regime.

3

Thanks. Yes, was told I had heart failure when I was in hospital last year with the 30%-35% ejection fraction reading. Glad to see the improvement since then, and physically I feel a lot stronger than I did then - below the neck, anyway. I don't really have any of the textbook heart failure symptoms like wheezing, fluid retention, etc. - a bit of a cough occasionally but that's just as likely a side effect of the meds, and it's pretty mild anyway.

Cholesterol had been down at 3 but has gone up recently to 4 point something (can't recall the exact number). Unsure about HDL vs LDL etc. - didn't ask the doctor but could find out easily enough.

I almost always feel worse in the mornings. Unsure whether it's because of the meds I take at night (atorvastatin, ramipril, bisoprolol) or some kind of sleep problem. Have been tested for sleep apnoea in the past, but results were borderline/negative.

4

Doctor suspected side effects from eplerenone in particular - asked me to stop taking it for 2 or 3 weeks but it made no difference, so I guess that's not the problem.

5

So heart failure is the reason for the drug regime. Your cholesterol is about normal level but should be lower with that dose of atorvastatin so ask to try a different one because the one you are taking is not effective. You could try splitting you Bisoprolol into 2 doses and taking the statin in the morning but it will be a case of trial and error til you find the right combo for you. The cough is a classic side effect of Ramipril. I could not take it and now take Losartan instead.