New Here - Are Beta Blockers necessary?

[carolinemc]

They do the beta bloc

Hi! I’m so happy to have found a forum like this. I am 35 years old and was diagnosed with an Enlarged Aortic Root when I was in my 20s. And I believe bicuspid. At the time it was 4.0cm and they just told me to ignore it. A few years ago I started to get screened again and now I’m at 4.1cm - so very happily not much growth in 13 years.
Despite this my cardiologist recommends that I take a beta blocker Toprol XL (I suppose for the rest of my life). My blood pressure is normal (last check was 116/70) and I don’t have any obvious symptoms so I am very hesitant to take beta blockers forever. Does anybody here have any opinions on this?

They do the beta blockers till you have replacement surgery. They want to do as much as possible to hold off surgery till it is a necessary. I bet you have fatigue, which is common with your condition. You may not have to take them forever. Just follow the doctor till you have surgery to correct your issue. Take care and Have a Happy New Year.

 

[carolinemc]

I was given beta blockers post surgery. At three weeks the dosage was halved and then stopped completely at six weeks.

@Snwbrd031 - I see you're not asking about post surgery beta blockers - if you're concerned about being prescribed beta blockers now can you get a second opiniom ? Or have you got a blood pressure monitor ? If so perhaps ask the doctor if you could lower the dose of beta blocker leading to a trial with out it ? My blood pressure is always high in any medical situation, even with the nicest doctor, so it's sometimes suggested I should be prescribed something for my blood pressure. instead I now monitor my blood pressure myself for at least two weeks before any cardiology appointment (with upper arm cuff monitor same as hospital's), I take it several times a day and record it all and print out the results for the cardiologist so he can see what my 'normal' blood pressure is. I also sometimes bring my blood pressure monitor to the appointment and the doctor takes my blood pressure with both his monitor and mine to check the accuracy of mine - it is accurate and always as high as the doctor's monitor in the hospital !

My blood pressure is weird to say the least. Low when I was a smoker, normal before surgery and after, now with diabetes, normal with that. No beta blockers for it. But I even monitor it when I go to the doctors and lab for Protime. Nice to keep up with it. Lets me know when my stress levels are up.

 

[carolinemc]

Hi there! I just noticed your post and I would agree with your thoughts in the last post. I go to KU Cardiology and while I've been on a beta blocker, they said I could stop it as I was "stable". Like you, I was right at 3.9-4.0 but I was in my early 30's when it was detected. I'm 38 now. My doctor feels a beta blocker isn't necessary unless 1) I have symptoms along with the dilation, such as POTS or 2) There's an increase in size. I did have an increase in size in 2018, but a beta blocker was not added. I suspect one would have been added if i would have had another year where it increased, but it's been stable.

This is something I've done a lot of personal research about and you do read a lot of conflicting information. It's good that you are trying to be as informed as possible!

Hi fellow Missourian, I am from KC. And did once go to KU on Rainbow. Miss the place as I now go to UH. formally Truman. I love most of the doctors and the up and coming ones. Welcome to the board. And it is hard being more informed than some of the Cardios. But we have to be pro-active for our lives depend on it.
I even have to go the extra mile for my diabetes. just got a new meter and the lancets and strips are mostly paid by Medicare, which pays 80% and I pay less in co-pay.
Glad that you are stable. Hang in there.

 

[Eva]

As of nowmy thought is to not take beta blockers and check the size again in a year. I want to know if it’s possible to stay the same size without taking them.

I wouldn't do that without the doctor’s approval! He knows your heart’s needs. I regret having stopped my Toprol when my doctor was against stopping it despite my complaints. When I moved to another city, the new cardio thought I was fine, my BP was fine. So, he agreed to stop them.
Three years after having stopped taking them, I had two episodes of AFib and developed an aneurysm (4.2).

Having this happened to me doesn’t mean it may happen to you! But I wish I listened to my first cardio!
good luck.

 

[pellicle]

I regret having stopped my Toprol when my doctor was against stopping it despite my complaints. When I moved to another city, the new cardio thought I was fine, my BP was fine. So, he agreed to stop them.
Three years after having stopped taking them, I had two episodes of AFib and developed an aneurysm (4.2).

firstly I'm sorry to read that you had the AFib and have a bouncing baby aneurysm, but I am writing to offer the consolation that this may have not been caused directly by you stopping the Toprol. Life throws us things and its tempting to look for our own actions that may have been causal; I hope you don't beat yourself up about it.

Best Wishes

 

[Eva]

Thank you, pellicle. I totally agree.
And with age, I’ve learnt to accept “what I cannot change” and live and appreciate the present moment!
Best wishes to you too.

 

[pellicle]

And with age, I’ve learnt to accept “what I cannot change” and live and appreciate the present moment!

I find this version of the serenity prayer helpful at christmas gatherings

Happy Holidays

 

[DachsieMom]

I was on metaprolol briefly after AVR. It caused my hands to crack, bleed and peel, almost like a hard clear shell was covering them. My blood pressure was 70/50, although weirdly, I didn’t feel anything. Due to my reaction, my surgeon took me off it after about 4 weeks. I’ve had no issues. I did go on bp meds - losartan - last year, and it’s been fine. My surgery was 2015.

 

[pearjas]

Sounds like you’re just like me. So you’re off beta blockers now and it pretty much stayed the same size?

Yes it's been the same since the increase in 2018. The increase in 2018 was likely caused by a BP spike I had off and on that year (which we think was due to thyroid issues)...but my BP was not well controlled all year and that was one of the reasons the beta blocker was added (in addition to other trials of BP medications). Eventually, everything stabilized and they told me I could go off the beta blocker. I suspect another increase would have meant it was time for the beta blocker, but I've been fine since. I have an echo every summer.

 

[Amy]

I’ve lowered my Metoprolol dose to a quarter pill a day, 8 months post op, so it’s only 6.25 mg or so... but I get arrhythmias if I go any lower than that... Some people here said you just have to put up with the arrhythmias for a week, (after stopping Metoprolol) & then they’ll go away... but it’s so scary / stressful that I always just go back up to taking a quarter pill.

Someday I’ll have a competent cardiologist who’ll convince me I can make it the whole week. Until then...

 

[gregjohnsondsm]

Last week my cardiologist took me off Metropolol. Heart rate was erratic and dropping to below 30bbm during the night. Also I tested positive for Covid last week. Heart rates had been normal (70 - 80's) following AVR surgery in 2015. Now I have a monitor and am seeing erratic rhythms when resting. Three beats, pause, three beats, pause. Very regular irregular heart beat.
Has anyone seen a connection with Covid and messed up electrical heart signals?

 

[neo]

https://pubmed.ncbi.nlm.nih.gov/31252447/
I just saw this study, from 2019, that showed continuously using beta blockers helped prevent structural valve deterioration in those with bioprosthetic mitral valves. It would be interesting to see if this was true with all bioprosthetic heart valves and even TAVRs. Not sure if there are any other studies like this?

 

[dornole]

I’m another one prescribed beta blockers post repair, which was tough in me as I have pretty low blood pressure normally (usually 100/60 at the doctors office and it goes lower when resting.) I felt so tired on them and they took me off. Sometimes I think there’s a standard treatment and it’s worth questioning whether it’s needed for YOU and the risks of stopping.

 

[pellicle]

I just saw this study, from 2019,

certainly warrants further study that's for sure

while the 10-year freedom from SVD was significantly higher in patients with BB therapy (92.4 vs. 76.3%, p = 0.001)​

shockingly does continue to make the case for SVD becoming significant after 10 years though ... some here are in denial of this.

 

[pellicle]

...
Has anyone seen a connection with Covid and messed up electrical heart signals?

personally yes, and its well reported in the literature, for instance:

https://www.uptodate.com/contents/covid-19-arrhythmias-and-conduction-system-disease

The vast majority of patients presenting with a systemic illness consistent with COVID-19 will not have symptoms or signs of arrhythmias or conduction system disease. Patients may be tachycardic (with or without palpitations) in the setting of other illness-related symptoms (eg, fever, shortness of breath, pain, etc​

... but you know what they say ... its "just like a cold" ;-)

 

[Mike1959]

personally yes, and its well reported in the literature, for instance:

https://www.uptodate.com/contents/covid-19-arrhythmias-and-conduction-system-disease

The vast majority of patients presenting with a systemic illness consistent with COVID-19 will not have symptoms or signs of arrhythmias or conduction system disease. Patients may be tachycardic (with or without palpitations) in the setting of other illness-related symptoms (eg, fever, shortness of breath, pain, etc​

... but you know what they say ... its "just like a cold" ;-)

Totally agree with Pellicle

I had a dose of covid last April, and have since seen an increase in eptopic palpitations and various bouts of palpitations which can last a day or so.

What does help me is to increase the dose of bisoprolol for a couple of days - but always check with your cardiologist first

 

[skier]

But if your blood pressure was fine and your aneurysm is repaired I wonder why they still want you on them?

My doc said staying on beta blockers is to protect the unrepaired portion of the aorta. While it's much less likely to develop an aneurysm than the repaired portion, it's still a risk worth mitigating.