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What Are The Side Effects Of Lopressor?

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Posted on Mon, 20 Apr 2015
Question: Hello,
This site is great and has really helped me since I only get a few minutes with the doctor at a visit.

I had a/fib with fast heart rate 174, had cardioversion and was determined to have severe sleep apnea. 6-4 and 320 pounds at time. Sleep machine and Lopressor 25mg X2 eliminated and further occurance till Feb this year (16 months I was great). Back in hospital for sinus tachacardyya with heart rate of 120. Lopressor raised to 50mgX2 a day. Also Buspar for potential Anxiety (Im not depressed )Butterflies in stomach and basically feeling something is wrong (Flutter?). After 2 weeks, a pulse oximeter determined 83 Oxygen so another sleep study was done it was determined my sleep machine was defective and a replacement was issued. Pressure raised from 8 to 10. During this same week I received replacement CPAP I was given a ECardio event monitor. It picked up 1 sinus Tachacardyia and 1 possible Atrial Flutter. This was 3/5-3/18 time frame. On 3/19 I visited a respiratory Apnea specialist who determined the machine was set at right pressure but I needed a high volume CPAP. Purchased ResMed 10. Since 3/20 I have had no issues and sleep very well. I still get feeling rarely of some butterflies.

With that said, the Cardiologist stated since its 1 occurrence of flutter to continue to monitor and stay on medicine.
1-How would I know when I am in Atrial Flutter without 12 lead?
2-Can I have Flutter with a pulse of 80? Usually flutter will have a fast rate correct so I assume if I go into sinus tachacardyia I may be in Flutter?
3-What can I do to reduce flair ups, no constant high heart rates since new machine which is good. I have also lost 23 pounds and now at 297

Again thank you so much
doctor
Answered by Dr. Muhammad Ahmad (2 hours later)
Brief Answer:
I would need some info

Detailed Answer:
Hi,

Welcome to Health Care Magic,

I am Dr.Muhammad Ahmad, I have read your message and will try to help you in best possible way.

I would like you to give me some more info in this regard.

Here i will ask you some questions to guide our conversation,

1) Have your heart issues and sleep apnoea got better with loss of weight?

2) Do you work out and walk?

3) Does you heart beat get bad when you exert?

4 )How often do you get an episode of butterflies?

5) what did you last holter say?

6) what is you normal resting pulse?



Waiting for your input.

Dr.Muhammad Ahmad

M.B.B.S

Resident M.D. (Cardiology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Muhammad Ahmad (1 hour later)
1-Sleep Apnea events have decreased since new machine with hi volume. Less than .9 events per hour. Weight reduction unknown if helped but assume yes to some degree
2-Office job, do not work out but walk some during daily hours of day. Should I walk more? Afraid to get heart rate up to trigger event
3-Heart beat recovery takes longer than 10 minutes after heart rate is up except when in a sinus tachacardyia which takes an hour to resolve. No sinus tachacardyia issues since new machine
4-sometimes 2-4 a day, other days no issue. Last night at 6pm felt some and took Lopressor (regular time 7pm)and 1 hour later at 8pm it was gone.
5-It said 5 manual push normal and 1 sinus tachacardyia and 1 possible flutter. I will attach picture of letter
6-My pulse is usually 67-77 daily sitting in office and at home watching TV. Walking mid 80's, thinking about heart issues mid 90's. Relations with wife about 140. Recovery seems slow not within 5 min. the 140 rate does go to 105 withing 5 min.

With possible flutter, will I have it at heart beats of 70-90? Again the new machine has been great, Im just scared of having Afib and flutter occurences, they mentioned ablation only if it gets worse and to take rythomol if I have a rythym issue again. Thanks
doctor
Answered by Dr. Muhammad Ahmad (18 hours later)
Brief Answer:
Things look great

Detailed Answer:
Hi,

Thanks for wiritng back,

I have read your question and follow up response in detail and i have seen the holter report you uploaded, i will try to help you out in best possible way i can.


Here we have to understand a few things.

What can Afib or flutter do to you?

They say in medicine "ventricualr tachycardias kill you... atrial tachycardias ANNOY you"
that's what it can do.. it can make you feel butterflies in stomach or palpitations and it annoys you.

So i would like you not to get very anxious about it, yes do take meds ,do take care of it but don't get scared of it.

Here i would also like you to know that in healthy hearts depend very little on atria to function,only 20 % of healthy heart's output is contributed by atria and 80% is the work done by ventricles.

so if in a healthy heart atria are in flutter they cause no danger, except embolous formation and that too if they stay in continuous fibrillation or flutter for some days.

In a compromised heart, atria contribute 40-60% of heart's function, only in this case we really care about life of a patient if atria are not working well.

As your history and investigations tell us that your heart is working fine so one this is for sure, if there is an expisode of A-fib or flutter this is not expected to harm you.

You asked me if you can have butterflies (a-flutter) with 80 pulse? its rare but yes you can , this is called rate controlled A.F it just tells us that ventricles are working fine and drugs are working.

****Plz tell me one thing, did you ever notice during an episode of butterflies, if your pulse is regular or not? or you focused on rate?***

****would also like you to tell me have you got a saturation metre? how is your saturation doing after new machine?***

****Do you get day time solemness ?***

****Do you sleep well in night these days?***

***When was your last long episode of arrhythmia , by long i mean more than an hour***




Now i will touch some info you provided me with an will let you know what is normal and what ain't so that you can stop worrying about normal stuff.

>>"My pulse is usually 67-77 daily sitting in office and at home watching TV. Walking mid 80's, thinking about heart issues mid 90's. Relations with wife about 140. Recovery seems slow not within 5 min. the 140 rate does go to 105 withing 5 min"<<


What if i tell you that this is a good set of readings? it just tells me how good your machine and your new med dosing is doing.

68 pulse at rest is perfect, 80 in walking is perfect and 140 in excitement is super normal, its normal reduction in fine minutes shows your heart rate control is acting perfectly , so what are you worrying for ?

Those butterflies ? yes we are going to talk about them too, just tell me are you following me till now? and I would also like you to answer the queries i asked you.

They are improtant to continue our discussion to current situation.

Waiting for your input


Dr.Muhammad Ahmad.

M.B.B.S ( Licensed G.P)

Resident Cardiology.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Muhammad Ahmad (7 hours later)
Thank you so much. Your so detailed!

1-I get butterflies randomly even sitting down. Usually mid day and afternoon but less lately after new CPAP. I take Lopressor 50mg at 7am and 730pm. I feel a normal pulse beat but usually is around 85-97 beats during butterflies. They appear regular. Also around 6pm it appears like my heartbeat goes up and then when I take my Lopressor I feel good about 1.5 hours later (8pm). It goes up about 10-15 beats before I take dose but I usually eat between 5-6pm so the increase may be due to food digestion.
2-Saturation meter I would assume is like a pulse Oximeter to measure Oxygen levels. During day 97 plus. During machine issue I was 80-83. Heartbeat was very strong contractions. Since new machine I dont hear heartbeat anymore and sleep very well, sleep study showed 93% avg mean during sleep study with thier machine. My Sleep study showed 19 events per hour in 2013 when this all started and thats when I went on CPAP 8 pounds. My new machine is less than 1 event per hour. .5-.9 are my readings. Best ever and my pressure was set at 10. The new machine is a high volume so I get plenty of air intake and pressure.
3-Daytime solemness meaning depressed never. Lack of focus is sometimes because I am trying to fix my health issue. I do tend to think about it, like now writing my concerns. Because I am the Manager I tend to have more time on my hands. I have to admit always back of my mind.
4-I sleep GREAT, best I ever had the last 2 weeks on new machine
5-The only occurrence in my life I am aware of was Nov 2013, they cardioverted me with paddles, 8 hours in AFIB. 1 cardioversion restored sinus rhythm. Since then I have only felt 1 possible Afib for seconds when my CPAP was broken. My only issue is the sinus tachycardia which I haven't had in 2 weeks since my new machine. The only other issue was the Holter monitor picked up Atrial Flutter and heartbeat of 150 after relations with my wife. This was also during the old CPAP machine issue 3/7/15.

In closing, since my new machine I am much better. I still get butterflies but not as much. I am scared to get heartbeat over 100 to set off another event (anxiety or being cautious ?). I feel like Im not 100% but 90-95%. I hope the new CPAP machine gets me better so these go away but I would have thought after 2 weeks it would be gone. The atrial flutter really bothers me yet it was only a 6 second strip and when machine wasnt working 3/7/15. The last event was sinus tachycardia on March 16th or 9 days after flutter. I did have relations with wife last week without any discomfort or issues of heart going back down. It did however take about 30 minutes to get around 80 beats. I also wonder if I should take magnesium since I heard that helps. Last test showed 2.2 within range on blood test. Sugar is 94 good and cholesterol is 150 good .

Thank you so much, your so detailed
doctor
Answered by Dr. Muhammad Ahmad (1 hour later)
Brief Answer:
Things look great

Detailed Answer:
Hi,

Thanks for writing back in such detail,

I am just noting down things and i will let you know how things are going for you and what you have to do next, I will give you some tricks to control your pulse rate plus come suggestions about medicine usage they might help you.

I want to assure you that things are going to real betterment in your case and I think there is nothing to worry about anything but still I will try to help you get rid of these occasional butterflies and pulse issues as well.



I would need to know something about your food habits, because losing your weight is very important plus as you have this problem of getting butterflies after meal (though its natural to get raised heart beat after meals but still one can eat in a better way to control it)

1) Do you eat big meals? (binge eating)

2) Do you feel butter flies during sleep?

3) What diet changes did you make to lose your weight?

4) When you are close to your wife you get raised heart beat, but is it regular? does heart beat at regular intervals?

I hereby would like to tell you that after your new machine and medicine change your oxygen saturation percentage and your frequency of butterflies and tachycardia have really improved ,

You asked about magnesium well you can take Centrum vitamin combo every 3rd day this will replenish your calcium potassium and magneisum all three of these minerals help stabilize heart , magnesium 2.2 is perfectly normal though so you don't have to take specially the magnesium.

I apologize for this much questioning but i like to be in detail with my patients and for that comprehensive reply i really need to drain any relevant info out of your history so that i can help you better,

My next answer will hopefuly be my final impression and i will give you my suggestions in the end then you can stay in contact with me to give me feedback how things worked for your.

Stay blessed waiting for your input.

Regards .

Dr.Muhammad Ahmad.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Muhammad Ahmad (19 hours later)
Hello, thank you for all the kind words....
1-I did eat large meals in the past, since the event in Feb I have reduced the portions. I also do not drink any soda or pop. I do have 2 cups of coffee in morning.
2-No butterflies going to bed or waking up. My pulse is the lowest during the morning mid 65. As the day goes on it gets higher. by mid morning its mid 70's. Evening around 80-85 sitting. Take Lopressor at 7pm and by 8pm its mid 75. The butterflies come randomly but less frequent these days. The family Dr. put me on Bulspar for Anxiety thing I was having a temp bout. No issues in past of ever having Anxiety or depression. Not depressed. I did have a mild case of ADD as a child but no medication.One person said that may be my issue of why I am thinking about this so much.
3-eating smaller portions and no soda and pop. I have to admit my pulse would go into the 90's after I ate. I had read that eating smaller meals will eliminate or reduce the spike in heart rate. So basically I was motivated to eat less knowing it would help me. Again prior to starting to eat smaller meals my heart would shoot to 100 walking up a stairs and stay there for 30 minutes or after I eat go to 100. This was all during the sleep apnea machine being bad. Since then I dont have these rates of 100 that last long, actually it hasn't occurred since new machine .
4-Relation with wife may have heartbeat of 150 and it appears regular in sinus. I do remember the situation where they stated I had flutter on holter. It was after the event occurred and I felt a weird sensation briefly in my chest but went away after a few minutes. This was also during that time of bad machine. Since then after I had relations I hear my heart but after it seems normal but heart rate didnt return till 30 minutes to 80 range.

I have attached my only confirmed time in A=fib from nov 13 (174 Heart rate) and also a sinus rythmn strip from the firehouse (80 rate). I took rythomol then but this was sinus tach from what they said when they got there. Maybe you could tell me if you see flutter or anything else when I was in Afib that would give indication of potential issues today although in sinus.

You have been GREAT! THANK YOU SO MUCH
doctor
Answered by Dr. Muhammad Ahmad (1 hour later)
Brief Answer:
Here we go

Detailed Answer:
Hi,

Thanks alot for your appreciation ,

your kinds words and peace of mind is all what matters to me.

Now I think i have enough information regarding your problem that i can sum up my thoughts ,and suggestions.

You Attached EKGS's :

Well EKG's of 2013 are not really good they have atrial fibrillation , they have disturbed rhythm and they have premature ventricular beats, scary enough? yes it was but what if i tell you that your EKG of feb 2015 is perfectly perfect ECG, perfect rate, perfect rhythm not a single sign of flutter and it is as normal as you can get.

So what to do about it now? well the best thing you can do about it is to take your meds take care and forget the bad what happened, it happened to your, you got meds , a new machine and its cured.

Do you have to worry about a cured thing? I don't think so.

So you have to spoil your peace of mind for a thing which is a past now? I don;t think so ?

Do you second me in this ?:)


Your present condition:

You sleep well now.

You are active in life.

You breathe well now.

You are losing weight.

Haven't had an episode of A.F since long time.

Your Oxygen levels are great.

You are willing to have a change in your life and this is paying off.

Your heart beat is under control.

Your heart beat goes to 140 during relation (perfectly normal) it goes back to base level in 5 minutes (which is even better, slowly going down to base levels is a bad sign ) .

Even in your highest heart beat situations your beat is regular.

In my opinion you medical management is doing great for you, you are willing to change your life style and that's helping you too now all you have to do it is to stop thinking about it.

Don't let your self fall into vicious cycle ( pulse up>>thinks about it>>gets anxious>>pulse goes up>>thinks about it>>gets anx....)

Now start thinking about yourself as a normal person , when ever you want to see if you'r pulse if ok or not compare it with a healthy individual, you eat your pulse goes to 90 ...same happens to 70% of world's population, your are with your wife pule goes to 140 same happens to every one, you are sitting in office pule is on 70 , isn't that what you want? don't think much about it, just box it out of your mind this will help.



What happens when we eat?

Body is smart, it knows i have to digest and absorb the food into blood so for better absorption it sends a litre extra blood to intestines, when a litre of blood goes out of system heart has to pump more to compensate and irrigate other organs with blood? simple? ..


How can this me made better ? 2 glasses of water 15 mins before meal, avoiding binge eating, avoiding caffeine in food and dividing your daily total food into 5-6 small meals, can it get more simple?:)

Now we come to your "problem" of having comparatively rapid rate in evening:

Lopressor has a small half life that is 4 hours so if you took 50 mg after 4 hours 25 mg would have been removed from your body and after 4 more hours only 12 mg would remain and after 4 more hours only 6 would be there which is not enough to keep your heart rate down so it COMPARATIVELY goes up, though there is nothing to worry 80 beat per minute is perfect.

No here is what you can do :

1) Use it at start of 10th hour:

you can take it at 5:30 pm so that i can start working till 6:30,,, then you will not have a spike of heart rate in evening.

This will also let you take advantage of natural course of heart rate control.

Tha'ts how your heart rate will get controlled.



Lopressor(morning)>>lopressor (evening)>> natural slowing of heart rate because of sleep>>lopressor(morning).

So that's how you have to deal with occasional spikes:

Small meals, 1 hour early lopressor and deep sleep :) and yes if you can reduce your caffeine and coffee in take that would be great.

I am really happy and satisfied the way you have been progressing,

Don't forget that you have to keep losing weight ... your target is 200 pounds go for it, it will make your sleep apnoea better, will put less pressure on your heart.

Science is simple? small body>>small area to pump blood to>> low pressure on heart>>healthier heart .

So keep losing weight.

Eat healthy and stay healthy.

It was a pleasure talking to you.



I will be waiting for you to try the new suggestions and give me feedback if they worked. There are other options too which we can try in same medicine dose by simple altering way of taking it , but more preferred is what i told you.

You can directly discuss with me anything at.

http://doctor.healthcaremagic.com/doctors/dr-muhammad-ahmad/69304

I Hope this answers your question, if your have more queries feel free to ask, otherwise close the discussion and rate it. Wish you the best of health.



Regards,

Dr.Muhammad Ahmad.

M.B.B.S.( Licensed Family physician)

Resident M.D.(Cardiology)
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Muhammad Ahmad

General & Family Physician

Practicing since :2012

Answered : 1308 Questions

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What Are The Side Effects Of Lopressor?

Brief Answer: I would need some info Detailed Answer: Hi, Welcome to Health Care Magic, I am Dr.Muhammad Ahmad, I have read your message and will try to help you in best possible way. I would like you to give me some more info in this regard. Here i will ask you some questions to guide our conversation, 1) Have your heart issues and sleep apnoea got better with loss of weight? 2) Do you work out and walk? 3) Does you heart beat get bad when you exert? 4 )How often do you get an episode of butterflies? 5) what did you last holter say? 6) what is you normal resting pulse? Waiting for your input. Dr.Muhammad Ahmad M.B.B.S Resident M.D. (Cardiology)