Need Info - Beta Blocker?

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L

Linda

I have MVP with moderate regurgitation and saw my local cardiologist yesterday for my 6 month check-up. After examining me and listening to my heart in all the various ways, he asked if I ever feel my heart pounding and beating very fast. I said "yes, that it happens but I've just learned to ignore it" He said that while listening to my heart, it was beating over 100 beats per minute and that if I was having this symptom, then I should be taking a beta blocker. I asked if any damage would occur to my heart if I didn't take the medication. He said that since the heart is beating harder that with time it could cause the heart to wear out sooner. He wants me to take 25 mg of Toprol-XL per day. He said that it can make you tired and to take it at night and if my blood pressure gets too low, then I should eat something salty. I tend to have low blood pressure anyway 110/70. The nurse told me to take it for a week and then come back next week to have my blood pressure checked. I'm really not happy about going on this medication since I've read a lot of negative side affects from those taking beta blockers. I've also read where some people say that if you take potasium and magnesium that you won't need a beta blocker. Any comments/information would be greatly appreciated! Thanks.
 
Hi Linda,

I have some information to share regarding Beta Blockers. I have been on Atenolol for almost 2 years and have not had any serious side effects. However, I know that some folks do experience side effects, as is the case with almost any drug.

I would strongly recommend that you STAY AWAY from the Lopressor family of Beta Blockers. That includes the time release versions, they cross the Blood / Brain Barrier and often cause depression due to that.

I have copied some more complete information about these drugs below.

For simplicity sake (though nothing seems to be that way in medicine today), doctors, using their overall clinical experience, try to prescribe a beta blocker that is felt to be the most appropriate one that will effectively control a particular condition or conditions (dosage must be individualized) and do so hopefully with minimal (tolerable) side effects.
Contraindications, pre-existing medical conditions and drug interactions have to be taken into consideration when prescribing this particular drug as well.
Beta blockers can be cardioselective; decrease in systemic side effects and only affects beta-1 receptors located primarily in the cardiac muscle or non- cardioselective; increase in systemic side effects; and affects beta-1 and the beta-2 receptors (which are located primarily in the bronchial musculature and blood vessels).
Toprol-XL® (metoprolol succinate, extended release) is a beta-1 cardioselective drug. Metoprolol tartrate immediate release is availble as Lopressor® and is reported to be the most widely prescribed and competitive beta-blocker in the world.
In the U.S., Toprol-XL® is primarily indicated for high blood pressure (hypertension) and angina, but like other beta blockers, it can be prescribed for other conditions as determined by a qualified doctor.
Since everyone is unique, and therefore the metabolism responds differently to beta blockers, if a particular beta blocker works well for one individual that does not necessarily mean that it will work well for the next.
A problem with this class of drug is that some beta blockers are known to enter or cross the blood-brain-brain (BBB, actually there are two of them and is described as a protective network of blood vessels and cells that filters blood flowing to the brain) easier than others.
The ones that do this seem to cause more central nervous system (CNS) side effects, such as nightmares, hallucinations, and depression than others that exhibt low penetration characteristics (LPC).
If a beta blocker seems to be ineffective, doctors will either increase the dose or switch to another class of drug that is deemed appropriate.
When a beta blocker dosage is increased, one has to watch out for dose delivered side effects (DDSE) which can be an increase in the severity of present (if any) side effects or the onset of entirely new ones which may or may not cause an iatrogenic condition or disease.
Also, while on this class of drug, blood pressure and pulse/HR should be checked regularly and a doctor should be contacted immediately if/when pulse/HR falls below 50 BPM.

NOTE:
The fat-soluble variety of beta blockers such as Inderal®, Lopressor®, and Toprol® XL cross the blood-brain barrier rather easily.

This apparently is why that variety causes more central nervous system (CNS) side effects, such as nightmares, hallucinations, and depression, than the more water-soluble beta blockers that do not cross into the brain as easily such as Tenormin® and Corgard® and usually do not influence mental function.

I hope this info helps, I do have more, but think this will get you started.

Good luck,

Rob
 
Like Rob, I have been on Atenolol for some time - even before my quad bypass surgery. Very quickly after surgery I felt that my heart was pounding (within days of coming home) and called the dr's office. He upped me from 1/day to one/morning, 1/night. I don't seem to have side effects, but sleep like a contented baby and perhaps the med helps this. My dr said the heart would wear out quicker if not slowed down - like Rob said. God bless
 
Thanks!

Thanks!

Rob and Hensylee,

Thanks so much for your responses and information. When my cardio calls with echo results, I'm going to ask why he has chosen Toprol-XL rather than one of the other beta blockers which possibly wouldn't have the same side affects. I'm also going to try to research the Potassium and Magnesium affect on stabilizing the heart rate. Thanks again and God Bless!

Linda
 
Linda

Linda

Linda-
See, this is why I need to start checking everyday on here.

I want to echo what Rob said about the blood-brain barrier. I was on Nadolol (Corgard) for two years and had some weird epidoes where I felt as if I was having a stroke, couldn't remember where I was, etc. The doc thought the beta blocker had breached the blood-brain barrier and that this is what caused those weird episodes.

post-op I was on Toprol and felt fine.

I never had any trouble with low blood pressure and felt tired but that was because of the bad valve not the drugs.
-Mara
 
Hi Linda

I'm currently taking 100mg Toprol XL for exactly this same condition. I was in tachycardia most of the time (usually 110 bpm or more). My cardiologist said we needed to try to slow it down to determine if my aortic stenosis was requiring my heart to beat this fast to deliver enough volume, or whether the rapid rate was unrelated (I reminded him that I've had rapid heart rate for 20 years). If I got faint or weak, that would be a clue that they were related.

Fortunately, I've tolerated it well and my pulse is now down in the low 80's. The doc says this will get my heart in better shape for my eventual surgery in a couple of months, and overall I really do feel better.

I do get sleepy from it in the early evening, but I wouldn't call it "fatigue", just drowsiness.

I was on Atenolol about 10 years ago for mild hypertension and had breathing problems and weakness in my legs from it.

I recognize the other posts on this topic and don't mean to confuse or contradict, but this is my experience. The thought of being on a beta blocker didn't sit well with me either, but it hasn't been that bad for me. Definitely hold your doc's feet to the fire as Rob suggests...I sure wouldn't be taking them if I didn't need to!

Johnny
 
Learnt something new...

Learnt something new...

I didn't know that the simplicity with which some medications pass through the blood/brain barrier can cause or add to depression. Kinda makes me wonder how much of my depressive episodes over the years has been due to the numerous drugs I have been on and which was "real" depression... Oh well, you learn something new each day -- thanks!

/jessica :D
 
Hello again.......I have read most of the "personal stories" that have been posted. I hopefully will be able to post my story soon. Though I didn't see any reference to Marfan Syndrome in any of them, was wondering if anyone else has it or knows of someone who does.


Thanks---- Merryreader:cool:


"When it comes my time I will not worry about the actual dates, it's that little hypen in between that will tell the story of my life."
 
Question on how re -beta blockers

Question on how re -beta blockers

:( Hi Linda, Just read your post. I had my tissue valve replacement on Jan. 24.2002. Almost from the start I had rapid heart beats and no one seemed to be to alarmed. When I saw my cardio 2 weeks later, I told him of my questions of the heart beat being to loud and fast. He said not to be alarmed, I would get used to it. Then 2 weeks ago I saw my primary dr. Told him the same thing and he said he would give me Antenol 50 mg , l a day. I go back 3-8-02 for post-op check.. I just starting taking it Wednesday 3-6-02. To tell you the truth I'm really scared of the medicine and all it's side affects. I've read all the post from Ron and it still scares me. I would appreciate any information you have on this or previous input. I go to this web site for everything. It has helped so much, and it's great support for new people after surg. and just about to have surg. Thanks . Bye Syl
 
Just read all the posts on beta-blockers. I've been on Atnetol 50 mg for about a week. No real side effects at first, but now a week later I've been having dizzy spells which really have me alarmed. Any one know or had this too? Kinda a light headed. No other side effects that I've noticed. Need help. Syl
 
Syl-

One possibility among many is that beta blockers lower your blood pressure and you might be experiencing drops in blood pressure which can be especially noticeable when you get up from sitting, bending over, etc. After a while this may go away, but just to be safe I would call the doc and get his/her take on it.
 
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re-beta-blocker problems

re-beta-blocker problems

Thanks Nancy. Good of you to answer so fast. I will call the Dr. today. and your right it mostly happens when I get up and move around. While I'm sitting down and doing nothing I don't even notice it. But to be safe I'll call him. Really had me scared. My family is so worried too. Does that mean the tingling in my finger tips and toes is the same thing, low blood pressure? Thanks again Nancy. Bye Syl
 
Hi Sylvia,

I had the same experiences. I am also on Atenolol 50 mg per day, and had the light headedness, and the cold and tingling fingers and sometimes even felt it in the head.

It did go away after my body got used to the medication. I still think it is a good idea for you to let your doctor know you are having these symptoms.

Wishing you good health,

Rob
 
Symtoms on beta-blockers

Symtoms on beta-blockers

If you look closely,you'll see "There'san Angel on

yourshoulder"Thanks Rob, your always there for us. I just called my Dr. and his nurse is going to relate my symtoms to him. I asked her if it sounded serious, she said probably not. But he will get back to me. How long does all this last? Getting a slight headache too. Syl
 
Hi Sylvia,

It lasted for about 4 to 6 months, (off and on) in my case. It has been almost 2 years now, and on rare occations I may feel the coldness or tingling in my finger tips, but the light headedness / dizzyness is gone.

Hope the doctor has some answers for you. By the way, do you have a home Blood Pressure / Pulse testing machine? You could monitor your blood pressure, and see if it is too low, perhaps a lower dose of Atenolol may be the answer. Well, that is for your doctor to answer.

I have a home blood pressure testing machine and test myself on a regular basis. I also record the results onto a chart so that I can bring it to my doctors when I see them. It seems that I get what they call " white coat" syndrom. My blood pressure goes up when I see a doctor... It also seems that when that happens, they want to change or put you on drugs. Well, with my chart, I can show them my blood pressure history and they have a better picture of it, than just that one test in his office on my visit.

The home testing blood pressure units are not expensive.

Keep us posted on what your doctor says,

Rob
 
Hi linda,
I starting taking atenonol 50 mg (which is the same as Toporal) a day along with accupril 20 mg which is an ace inhibitor 1 x a day after I had what they felt was a mini stroke. I believe i felt tired at first. After getting out of the hopsital I did not feel well. I feel much better now and think it has to do with the medications.
I also don't have high blood pressure. He seems happy to keep it a low normal. Its been over a year and I haven't had any change in my heart so I guess the medications are doing their job.
I have MVP with moderate to Severe regurgitation. My doctor is always talking about how great the ace inhibitor is at easying the heart. Any change in my ejection fraction, increase in my left atrium could send me to the operating room.

I'm going to be needing repair of my mitral valve someday. I'm 42 years young.
Sometimes the benefits outweight the risks.
 
Beta-blockers, et. al.

Beta-blockers, et. al.

Like Rob, I have the dreaded "white coat syndrome" so I test my BP and keep a copy of the results to give to any doc I have to see. I have a $120 Omron digital unit and it's pretty accurate.

As a matter of fact, I'm seeing my cardio for a two-year follow-up this Monday. Knock on wood, nyuk, nyuk, I think everything will be okay?

I'm a double-valver and take the following daily meds: Digoxin (0.25mg), Altace (20mg), Toprol Xl (12.5mg), Ecotrin (81mg) and Barr Warfarin (alt. days of 2.5/5.0).

Johnny: Man!, you must feel like molasses sometimes with all the Toprol you have to take!? A whole tablet just about knocks me out. I also supplement with Vit. E, Magnesium (500mg daily), Vit. C, Selenium and a Centrum Silver.

I'm also a Soy Protein advocate and have a 25g protein drink every day to compliment the Red Yeast Rice I take for Cholesterol. Re-testing this summer as I will have been on this regimine for a year.

I think I feel my best when I exercise! I've got the "gym-rat" syndrome like Rob too.

Hope this helps somewhat.

Cheers.
 
I've been on Metoprolol Tartrate (25 mg twice a day) since a few days post surgery. My normal blood pressure pre-op was a very normal 120/70 most of the time. Post-op it has ranged from 115/75 to as low as 90/60, though it stays in the higher range now that a few weeks have passed. I have experienced a bit of lightheadedness and dizziness at times, but nothing that causes great concern. No other side effects that I can tell. Despite the medication I still feel my heart is beating more forcefully than normal.

Alan
 
Re-beta-blocker

Re-beta-blocker

Hi Rob, well after about a week taking the beta-blocker, I feel much better , thanks to all your good information and web sites. I can always depend on you to come up with just what I needed. Many thanks to you again. Syl
 
Re-beta-blockers

Re-beta-blockers

Hi Alan, How are you doing with working at home now? Are you still having pain in your back? Hope the weather is better up there. California is haveing a little rain but not enough to really tell if it was rain. But today its clear and starting to warm up a little. I'm doing better with my beta-blocker med. Not getting dizzy or lightheaded any more. But my strenght is just not what it used to be. I'm starting my 8th week today. I probably won't go back to work for another 3 weeks , since my dr. won't let drive yet. I see my cardio. dr. this afternoon for a check up. and ask a few questions that need answered. Well hope your doing fine. Syl
 
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