Newbie introduction & question

[DanielB]

Hello everyone. First, I want to thank everyone who make this such a great source for heart valve information and support. Since finding it, I have learned more than in all other resources combined. About my situation, I am a 52 y/o male (53 on Monday!) who was diagnosed with moderate to severe AR one year ago (by accident really, but that's another story). The diagnosis was confirmed through an echo and TEE and I was told I'd be in the waiting room for (5) years and put on semi-annual echos. I felt just fine going into the initial diagnosis, but after being put on ACE inhibitors by my cardiologist (Lisinopril and Amalodapine) to lower my lifelong BP of 133/85 and to gain the other benefits from that. It took six months to get to a level that my body seemed to accept. One I went to a standard dose, I was fine for a month or so, then started getting days where I was a bit lightheaded, a bit nauseous and a slight headache -- generally just feeling crummy for a few days. So, fearing it was something related to my heart, I went to my Cardio and he decided it was the ACE inhibitors, not my heart causing the issue. He told me that if I could stand the side effects, the benefits were really good for my heart and Aorta (which is enlarged), so I have been trying to work through them until I see him again in a couple of weeks after my next echo. Also, in the last few months, I have been extremely tired most of the time.

My question is, did any else have a similar experience with side effects and being really tired after getting into a regular regime of ACE inhibitors?

Sorry about the long post -- so much to say getting started.

Dan

 

[dick0236]

My question is, did any else have a similar experience with side effects and being really tired after getting into a regular regime of ACE inhibitors?
Dan

Welcome Dan, good question....and it got me thinking about my own situation. I was put on an ACE inhibitor (Lisinopril) 40mg/day several years ago. I began to be tired, needed daily naps and slept 10 hous per nite. I thought it was "old age":redface2:. A few weeks ago, my cardio cut my dose to 20mg/day (I complained about my dry cough). Since that dose reduction I have more energy and have gotten into a 7-8 hour sleep schedule.....I still like an afternoon nap every now and then:angel:. May be coincidence????....but it may have been the higher dosing. We'll see:confused2:

 

[DanielB]

Thanks for the reply. My Lisinopril dose is 40 mg/day as well. one of the things I hate about these drugs are they cause symtoms that can sloe be heart problem symtoms as well. What I know for sure is, so far the treatment has been worse than the ailement. If mt cardio feels the tiredness is caused by the ACE inhibitors, I'll definately be pressing him for a change in dose or dropping them altogether. My day to day life was much better before I starting taking them for sure.

 

[Greg a]

Daniet , a heart felt WELCOME to our OHS family glad you are getting some of the information that you are seeking since you joined in December and there is swealth of knowledge here for the future .....

-a list of acronyms and short forms http://www.valvereplacement.org/forums/showthread.php?27413-List-of-Acronyms-and-Glossary

-what to ask pre surgery http://www.valvereplacement.org/forums/showthread.php?26668-Pre-surgery-consultation-list-of-questions

-what to take with you to the hospital http://www.valvereplacement.org/forums/showthread.php?13283-what-to-take-to-the-hospital-a-checklist

-Preparing the house for post surgical patients http://www.valvereplacement.org/forums/showthread.php?19034-Getting-Comfortable-Around-the-House&p=218802

These are from various forum stickies and there is plenty more to read as well[/

 

[epstns]

Daniel, I have not had to take any ACE inhibitors, but I do remember that when I initially started an angiotensin II receptor blocker (ARB) for hypertension, I felt a reduction in my energy and got tired more easily. I attributed it to lower blood pressure, but eventually I got used to it.

 

[LeakyUK]

I am on 15mg Lisinopril & my GP does not want to push it up past 20. I have had regular blood tests for Liver and Kidney function. I get very tired on an evening but am also taking anti depressents to help me sleep. Once your BP settles you may be able to slowly reduce the dose ( Mine is down from 185 to 140 - it shot up from 135 when surgery was diagnosed & I went into blind panic and depression!)

 

[DanielB]

Thanks to everyone for the replies. I have been having some added coughing and have thought the coughing during the day was simply an extension of the ones I have at night when mt lungs tens to load up, but, in thinking more about it, my daytime coughs are really dry coughs -- something that could certainly be the Lisinopril. All in all, some good insights to take to my cardio when I see him on the 26th. Thanks again.

Dan

 

[Bryan B]

Daniel,

Just so you know Amlodipine (Norvasc) is a calium channel blocker and not an ace inhibitor. I haven't been on Lisinopril but I have been on Enalapril before (10mg twice daily pre-op) as well as Metoprolol (on 50mg twice daily now) and Diltiazem (360mg CD daily for a short period of time when I had A-Flutter). So that covers ace inhibitors, beta blockers, and calcium channel blockers. With each of them I have had some degree of fatigue. I haven't really experienced headaches except when I had A-Flutter and my heart rate was constantly much higher than normal even when on the drugs to bring it down. I think the times I have experienced dizziness is when my B/P was low, and when they reduced the dosage to get it back in the normal range the dizziness went away. It really is a matter of benefit vs risk with taking these drugs. I think anytime you can safely put off the surgery for a few years that is a few years you buy down the road for advances in technology. I am not a doctor but with moderate to severe regurgitation it sounds like you are right at that fine line between needing surgery now and watching it closely. You might even want to get a surgeon's recommendation as well as your cardiologist's recommendation. If a surgeon says wait I would feel comfortable waiting and having it watched closely.

Hopefully with some dose adjustments and some time your body will get used to taking the B/P medications and your symptoms will subside.

 

[Bryan B]

BTW when I first talked with my surgeon he brought up the option of taking an ace inhibitor for 6 months and then re-evaluating my condition. But he also said that I will be having this surgery, it's just a matter of whether we do it now or a few years from now. I was already having symptoms so i opted to go ahead with the surgery. I chose the Ross Procedure hoping that it would last much longer than a tissue valve (I was 43 at the time) and possibly indefinitely. Unfortunately I developed aortic root dilation and just recently had surgery to replace the autograft valve, root, and part of my ascending aorta. This time I didn't have a decision to make because my root dilation was getting dangerously large.

 

[DanielB]

Thanks Bryan,

I had forgotten that the Amalodapine was a calcium channel blocker. Certainly, some of the side effects of that are what I am seeing as well. You are right in that I am getting close to where surgery would be called for and I am certainly going to be taking a close look at that after the my echo next week and the follow-up discussions with my cardio on the 23rd. My aortic root is enlarging and, as of my last echo, I was told my heart was showing some enlargement, so, as you can imagine, I'm anxious to see where everything is in this update. I feel I am getting close and if the numbers bear it out and my cardio is still hesistant to move ahead, I probably will seek a surgeon's opinion. I know the surgery is major ansd is not without risk, but I am really at ease doing it sooner than later.

 

[scott.eitman]

Hello everyone. First, I want to thank everyone who make this such a great source for heart valve information and support. Since finding it, I have learned more than in all other resources combined...
My question is, did any else have a similar experience with side effects and being really tired after getting into a regular regime of ACE inhibitors?

Sorry to hear you are experiecning this. I was as well. I have been on and off Lisinopril for about 20 years. I have never felt a side effect like you mention. I would look at the Amalodapine. I was on Metoprolol after surgery and feld very similar to how you feel. Yuch!!! It was awful. I worked with my Cardio a few weeks ago to slowly come off of it and now I feel good again.

You might be interested in reading a positng I had on Low Stamina: http://www.valvereplacement.org/forums/showthread.php?37880-Low-stamina&referrerid=7522

 

[DeuxofUs]

Hi Daniel! (waving from Encinitas)

I was on Lisinopril but it gave me a nasty cough... especially at night.. ugh! So, I am on Diovan now in the mornings. I am also on Meteoprolol 25 mg at night.

I do think the meds make me a bit tired but my blood pressure shot up in my late 30's... I am 41 now. It had to get under control. Then I just found out about my BV last Feb... I think my blood pressure has something to do with my BV.

Sometimes it's just a matter of time to equalize out from meds but I would say if you are coughing mroe than normal... it's the Lisinopril. That is a very common side effect that docs forget to tell you about. Why, I don't know

Anyway, welcome to the boards and keep us posted!

 

[Jkm7]

Sometimes they don't mention possible side effects due to 'power of suggestion'. If one expects certain side effects, they might think they are experiencing them even if not.

When I was on lisinopril, my potassium level increased. That is easily tested and should be. High potassium is no better than too low. Maybe the possibility of increased potassium while taking lisinopril would make it a good combination for those on lasix which can lower one's potassium. These medications are such a balancing act and have to carefully monitored.

 

[DanielB]

All good info suggestions -- thanks again. As I mentioned earlier, I'm coming up on my semi-annual echo (in a couple of hours) followed by a visit with my Cardio Monday, then my annual physical the following Thursday. All this will certainly be a help in working with my doctors to see where I stand and to get me feeling better. Of course, if my cardioe tells me it's surgery time, that will be a game changer. I'll keep you all posted.

Dan