Unusually high HR ?

[zhpDEREK]

My husband, Derek, is on post-op Day 3. He was prescribed Metropolol also, 25 mg, 2x a day. In layman's terms, what does a beta blocker do? If Derek's heart rate can be controlled, will he still have to take it when he's discharged from the hospital?

They just did an EKG to check for pericardial effusion - no orders were given to drain, so maybe there's no extra fluid. RN confirms he does not have A-fib.

So.. we bought a weight scale. Should I buy a heart rate monitor too? Or is it ok just to count the beats manually?

~Jen

 

[Jason]

It was explained to me that the beta blockers block sites that adrenaline would attach to on the heart, thus stopping the adrenaline (secreted by the adrenal gland in order to get more blood pumping to the kidneys) from turning up the heart rate. Someone can jump in if they know this to be incorrect or not quite right, but this is what I recall being related to me by the pharmacist.

If Derek's experience is like mine, he will be on some dosage of metoprolol or other beta blocker after discharge, possibly up to 6 months after surgery. My particular surgeon administers this drug to get the heart slowed down and reduce blood pressure while the heart remodels. Many people can and do get off of it after the remodeling process is complete. At that point it will depend on his particular numbers and symptoms.

I hope that he doesn't need a drain, but if so I hope that all goes smoothly. I bought a blood pressure monitor and exercise heart rate monitor after surgery. The blood pressure monitor is both a blessing and a curse; it lets you know what is going on more frequently than a visit to the doctor or pharmacy, but it can also become an obsession. It certainly did for me, as I was checking too often and worrying the numbers. I have since dropped back to checking twice a day as recommended by the U 0f Michigan paper circulated here on the board. The exercise heart rate monitor allows me to see my heart rate and know when I need to slow it down during exercise. When I am at cardiac rehab I don't really need it, but when road biking, walking or running outside it sure comes in handy.

Glad to see Derek is progressing, and I hope some of this helped.

 

[normofthenorth]

I found some cheap monitors that have been helpful to me -- especially a $20 BP-and-HR cuff, and a $20 HR monitor with a chest strap and a wrist-watch readout. My BP hasn't been very exciting, maybe partly because I haven't been "worrying" it much.

If you don't mind stopping your walking (or jogging or whatever) to stick fingers on a wrist or a neck, and eyes on a watch, then you can measure your own HR fine with nothing but a watch. Me, I went downhill skiing at Whistler at ~8 weeks post-op, and I really wanted to get quick reliable readings during each (long!) ski run. My monitor gave me that, worth every buck and more. OTOH, the chest strap gave me some skin irritation and (EXTRA!) itchiness, so I stopped wearing it on normal days, even when I'm bicycling or doing walk-job cardio exercise.

My experience with Metoprolol was basically positive -- in fact, I wish the hospital's resident Cardiologist had NOT discontinued it when I was discharged. Three weeks post-op, I had a bout of A-fib and a trip to the ER, and I went back on Metoprolol, at twice the dose I had in the hospital (50mg/d vs. 25, each split into two half-doses). I'm guessing that I would probably have skipped the ER visit if I'd been on Metoprolol all along, but we'll never know for sure. At 3 months post-op, I went off the Metoprolol, and that's good, too!

I think Metoprolol and the other BBs generally depress the HR, and also have a more particular effect on HR elevation (Tach) that's caused by A-fib. I'm not sure if they help avoid A-fib itself, or just its effects on HR.