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My Wife Aged 90, Has High HR And Low Blood
Question: My wife aged 90, has high HR and low blood pressure, i.e., HR 94, BP 95/54, today, mode BP in high 90s and diastolic in 50's. Is there medicine that can remedy these numbers? She is under the care of a Cardiologist and a Nephrologist. She is taking Amiodarone, 400 Mg/day. She has Afib, periodically. She feels that more can be done to lower HR. She is unsteady upright some times. She is also taking Keflex for a knee infection.
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on Ask a Doctor service!
I passed carefully through your question and would explain that her high heart rate could be related to low blood pressure.
Coming to this point, I would recommend increasing salt and fluid intake in order to help raise her blood pressure values.
As she is taking Lopressor, you should know that this drugs main action is on the heart rate, by lowering it.
So, another option would be to increase Lopressor dose, but gradually, in order to avoid fatigue and further decrease in blood pressure values
Hope you will find this answer helpful!
I remain at your disposal for any further questions whenever you need!
Wishing good health ,
Dr.Ilir Sharka, Cardiologist
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on Ask a Doctor service!
I passed carefully through your question and would explain that her high heart rate could be related to low blood pressure.
Coming to this point, I would recommend increasing salt and fluid intake in order to help raise her blood pressure values.
As she is taking Lopressor, you should know that this drugs main action is on the heart rate, by lowering it.
So, another option would be to increase Lopressor dose, but gradually, in order to avoid fatigue and further decrease in blood pressure values
Hope you will find this answer helpful!
I remain at your disposal for any further questions whenever you need!
Wishing good health ,
Dr.Ilir Sharka, Cardiologist
Above answer was peer-reviewed by :
Dr. Prasad
Specifically is there any way to control or reduce her Afib more than what is being done? We realize her taking Amiodarone controls her Afib to a certain extent. Is there any more than can be done in that direction.? Does her being 90 restrict what can be done or is what is being done is normal remedy regardless of age. She is also taking coumadin and it runs in a normal range.
Brief Answer:
My opinion as follows:
Detailed Answer:
Hello again!
I understand your concern and would explain that Amiodarone is a good treatment option to help control atrial fibrillation.
Anyway, the dose that she is taking actually is a high dose and it can lead to some adverse effects like arterial hypotension, which she is experiencing.
For this reason, a possible option, would be to reduce the dose of Amiodarone and if the heart rate increases, to raise the dose of Lopressor in order to help control her heart rate.
Another option would be to stop taking Amiodarone and switch to a calcium channel blocker (Diltiazem, Verapamil) for atrial fibrillation. In such case, it would be necessary to closely monitor the liver function tests.
Another option would be to stop taking Amiodarone and start Digoxine for rate control, combined with Lopressor, which she is currently taking.
Cardiac ablation would be a good treatment choice for atrial fibrillation, in younger patients. But at her age, although there are no contraindications, I am afraid that it may be a little risky.
You should discuss with her doctor on the above treatment options.
I would also like to review her cardiac ultrasound report and other blood lab test reports in order to be able to give a more professional opinion.
Hope to have been helpful!
I remain at your disposal for any further questions whenever you need!
Wishing all the best,
Dr. Iliri
My opinion as follows:
Detailed Answer:
Hello again!
I understand your concern and would explain that Amiodarone is a good treatment option to help control atrial fibrillation.
Anyway, the dose that she is taking actually is a high dose and it can lead to some adverse effects like arterial hypotension, which she is experiencing.
For this reason, a possible option, would be to reduce the dose of Amiodarone and if the heart rate increases, to raise the dose of Lopressor in order to help control her heart rate.
Another option would be to stop taking Amiodarone and switch to a calcium channel blocker (Diltiazem, Verapamil) for atrial fibrillation. In such case, it would be necessary to closely monitor the liver function tests.
Another option would be to stop taking Amiodarone and start Digoxine for rate control, combined with Lopressor, which she is currently taking.
Cardiac ablation would be a good treatment choice for atrial fibrillation, in younger patients. But at her age, although there are no contraindications, I am afraid that it may be a little risky.
You should discuss with her doctor on the above treatment options.
I would also like to review her cardiac ultrasound report and other blood lab test reports in order to be able to give a more professional opinion.
Hope to have been helpful!
I remain at your disposal for any further questions whenever you need!
Wishing all the best,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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