heart failure, breathlessness and ICDs

heart failure, breathlessness and ICDs

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Discussion

Huzzah

Original Poster:

27,521 posts

190 months

Sunday 13th October
quotequote all
I was diagnosed with heart failure last dec, after 4 months of tests. LV ejaculation around 27, increased to 36 with meds.
Its being treated with Entresto, Bisoprolol & Eplerenone. Doses were started low and increased over the period.
It was recommended 6 weeks ago that I have an ICD fitted, risk of sudden death and paroxysmal ventricular tachycardiawas was mentioned, so seemed sensible.

This was done a couple of weeks ago, due for my follow up tomorrow so preparing a list of questions.

Since the ICD was fitted (I don't think they see the need for the pacemaker function to be active) I've been even more breathless. During the summer I did some gentle hill walking, about 10k and felt ok, a little breathless on steep sections but no more than I would have been pre heart failure. Now not sure I could. I used to be able to maintain 5k per hour over all sorts of terrain, again I'm struggling now and after an hour or so need to rest or slow down a bit.

I've just returned from my regular dog walk, 3.5k and flattish, out of breath and wanting a sit down. I measured my blood pressure 75/60 pulse 72. Could my dose be too much?

My blood pressure has always been on the low side 100/60 is typical, angiogram shows no arterial problems.

65 yo, 176cm, 70kg, T1 diabetic.

Thanks for listening to my whinge

Jonmx

2,663 posts

220 months

Monday 21st October
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Are you Jeremy Clarkson? Sounds like you're doing all the right things. Just be a regular nuisance to your doctor and ask them for advice, checks on BP etc when you're worried. I have slightly different health issues, but my surgery and doctor are very supportive throughout.

ucb

1,040 posts

219 months

Monday 21st October
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There is the possibility that you are getting side effects from medication (espescially with BP that low) or you've had a deterioration in your LV function. Either way, speak to your GP. They may even send you directly to medical the admissions unit

Huzzah

Original Poster:

27,521 posts

190 months

Tuesday 22nd October
quotequote all
Thx both.

I have a follow up ICD appointment on Friday, I'll discuss with them.

pidsy

8,200 posts

164 months

Tuesday 22nd October
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Hey Huzzah - just to say, it took until my second ICD followip for them to set it up specifically for me.

When they put it in, it’ll run its default settings - not until you have your appointments where they will ask lots of lifestyle questions that they can tailor it for you.

I had some very odd feelings until they got mine right - it’s an incredible bit of kit and the variables that they can modify are extensive. It just takes time for your body and the implant to get used to working together.

2 years in - they’re still modifying parameters on mine.

Huzzah

Original Poster:

27,521 posts

190 months

Tuesday 22nd October
quotequote all
pidsy said:
Hey Huzzah - just to say, it took until my second ICD followip for them to set it up specifically for me.

When they put it in, it’ll run its default settings - not until you have your appointments where they will ask lots of lifestyle questions that they can tailor it for you.

I had some very odd feelings until they got mine right - it’s an incredible bit of kit and the variables that they can modify are extensive. It just takes time for your body and the implant to get used to working together.

2 years in - they’re still modifying parameters on mine.
They did tell me it was mainly for the ICD side of things. The pacemaker is set to min and may not need to be active currently.

Huzzah

Original Poster:

27,521 posts

190 months

Saturday 26th October
quotequote all
They've advised an increase of Bisoprolol, and taken at night to mitigate the dizzy spells.

'Adjust your expectations' and 'the new normal' is still ringing in my ears

carinatauk

1,435 posts

259 months

Sunday 27th October
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64 yo; T2; asthmatic; active [ish]; dog walking 2 / day.

I have AF; heart failure; EF <30; and 6 stents put in due to artery issues, so little chance of heart attack with that and blood thinners.

I am intolerant to betablockers as it affects my asthma. Even though I am intolerant, they still push me to take some due to my AF sending my BPM over 200 at times.

I have a single lead pacemaker due to BPM going to less than 20 and passing out [and 3 operations to repair my broken wrist as a result].

I have now reached the point of having asthma attacks at less than 200m sedate walking. They have recently increased my Entresto which has resulted all manner of side effects, including worse asthma attacks. Will be discussing reducing this next week with my GP as I can't function properly

I am due a scan on the 9th Nov and then they will decide whether to replace the pacemaker with an ICD; hopefully to control both low BPM and settle the AF but I know they will have the full function on which is a bummer as that means 6 months without a car.

So I feel for you and your situation. All I know is that the ICD is unlikely to improve too much, other than protect one from keeling over to young. The medication seems to be the factor [in my case] that is increasing the asthma problems.

All the best for the future and hope you get sorted soon

smiles1

544 posts

229 months

Sunday 27th October
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carinatauk said:
64 yo; T2; asthmatic; active [ish]; dog walking 2 / day.

I have AF; heart failure; EF <30; and 6 stents put in due to artery issues, so little chance of heart attack with that and blood thinners.

I am intolerant to betablockers as it affects my asthma. Even though I am intolerant, they still push me to take some due to my AF sending my BPM over 200 at times.

I have a single lead pacemaker due to BPM going to less than 20 and passing out [and 3 operations to repair my broken wrist as a result].

I have now reached the point of having asthma attacks at less than 200m sedate walking. They have recently increased my Entresto which has resulted all manner of side effects, including worse asthma attacks. Will be discussing reducing this next week with my GP as I can't function properly

I am due a scan on the 9th Nov and then they will decide whether to replace the pacemaker with an ICD; hopefully to control both low BPM and settle the AF but I know they will have the full function on which is a bummer as that means 6 months without a car.

So I feel for you and your situation. All I know is that the ICD is unlikely to improve too much, other than protect one from keeling over to young. The medication seems to be the factor [in my case] that is increasing the asthma problems.

All the best for the future and hope you get sorted soon
Could I ask what side effects you are having from the increase in Entresto?


carinatauk

1,435 posts

259 months

Sunday 27th October
quotequote all
smiles1 said:
Could I ask what side effects you are having from the increase in Entresto?
Sure:

Increased asthma / breathing problems
Dizziness / sickness
Headaches
Tiredness / weaker than usual
Sweats
Increased heart rhythm changes

Hope this helps