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What meds are best for pre-syncope caused by obstruction?

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  • #16
    Re: What meds are best for pre-syncope caused by obstruction

    Well, everyone....

    I am afraid my visit to the Dr. today was pretty anti-climactic. Basically, he told me to stay hydrated, and he wants to do another echo in a few weeks and then to talk to one of the two HCM specialists I saw a few months ago before he decides what to do. He doesn't think we should increase atenolol right now, or switch to/add something else until he sees whether my obstruction has increased.

    My last regular echo was resting gradient 60, but then I had a stress echo a few weeks later, and at rest gradient was 20, and following intense exercise went to 80.

    Well, as always, I guess we have to just stay posted. I fondly remember the days when I would just go to the Dr. and they would immediately fix me....no waiting, no tests,......

    Yuck!
    Daughter of Father with HCM
    Diagnosed with HCM 1999.
    Full term pregnancy - Son born 11/01
    ICD implanted 2/03; generator replaced 2/2005 and 2/2012
    Myectomy 8/11/06 - Joe Dearani - Mayo Clinic.

    Comment


    • #17
      Re: What meds are best for pre-syncope caused by obstruction

      With that gradient it sounds like a septal reduction MAY help OR simply stay WELL hydrated will help it.
      Hang in there!
      Lisa
      Knowledge is power ... Stay informed!
      YOU can make a difference - all you have to do is try!

      Dx age 12 current age 46 and counting!
      lost: 5 family members to HCM (SCD, Stroke, CHF)
      Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
      Therapy - ICD (implanted 97, 01, 04 and 11, medication
      Currently not obstructed
      Complications - unnecessary pacemaker and stroke (unrelated to each other)

      Comment


      • #18
        Re: What meds are best for pre-syncope caused by obstruction

        Well, my story continues....

        I saw the guy here in L.A. today who I suppose is my new cardiologist...I saw him for a second opinion regarding my ICD implantation recently, and he is the HCM expert to whom my EP doc is closest. Also, lucky for me, he is close by. At my EP's suggestion, I went to see him today.

        I had an echo which shows that my gradient and mitral regurg have gotten much worse. I didn't get the actual numbers, but apparently the regurg went from mild/moderate to more like severe, and the gradient was somewhere north of 80 mm, when it used to be non-existent, and then for the last year or so, was only 20.

        The doctor wants to increase me gradually from 50 mg. of atenolol a day to 100, and see how that does. If it doesn't help, then he wants to try me on Norpace. I guess I am somewhat relieved to hear that he thinks there is a reason for my recent symptoms which he can objectively see and treat, and that I don't seem to have to have the tilt table test that he had mentioned before. That didn't sound very pleasant.

        Oh, I forgot, he also wants me to take 1200 mg. a day of Motrin or Advil. 2 pills three times a day. He says that it will help keep me retaining water and has a vasoconstricting effect, which will help keep the fainting in check. I am also instructed to drink and eat salt....At least I like salt, but I still have to lose 20 lbs.! Well, maybe one day!

        Anyway, wish me luck. Hopefully this will help, but at least I feel like I am on the path....He told me that he is optimistic that we will get things under control.

        Stay tuned.....
        Daughter of Father with HCM
        Diagnosed with HCM 1999.
        Full term pregnancy - Son born 11/01
        ICD implanted 2/03; generator replaced 2/2005 and 2/2012
        Myectomy 8/11/06 - Joe Dearani - Mayo Clinic.

        Comment


        • #19
          Re: What meds are best for pre-syncope caused by obstruction

          Cyn, I'm so glad that you've got a plan of attack now. I know how miserable it is to feel yucky with no way to fix it. Good luck and keep us posted.

          Reenie
          Reenie

          ****************
          Husband has HCM.
          3 kids - ages 23, 21, & 19. All presently clear of HCM.

          Comment


          • #20
            Re: What meds are best for pre-syncope caused by obstruction

            At least we know WHY - now lets work on fixing it.
            RE the salt - tomato juice is a good souce of LOW FAT sodium (and you get your veggies too )
            Be well,
            Lisa
            Knowledge is power ... Stay informed!
            YOU can make a difference - all you have to do is try!

            Dx age 12 current age 46 and counting!
            lost: 5 family members to HCM (SCD, Stroke, CHF)
            Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
            Therapy - ICD (implanted 97, 01, 04 and 11, medication
            Currently not obstructed
            Complications - unnecessary pacemaker and stroke (unrelated to each other)

            Comment


            • #21
              Re: What meds are best for pre-syncope caused by obstruction

              Lisa - Thanks for the tip re: tomato juice. Although I would love to run out and eat alot of french fries, as it is I still have 15 lbs. to lose!

              My big crisis today was finding some clothes that fit to wear to my first job interview since my son was born 19 mos. ago!

              I told the doc yesterday I HAVE to start exercising again soon. By the way, I went up to 62 1/2 mg. of Atenolol today, and so far, so good.
              Daughter of Father with HCM
              Diagnosed with HCM 1999.
              Full term pregnancy - Son born 11/01
              ICD implanted 2/03; generator replaced 2/2005 and 2/2012
              Myectomy 8/11/06 - Joe Dearani - Mayo Clinic.

              Comment


              • #22
                Re: What meds are best for pre-syncope caused by obstruction

                Well...how did the interview go???
                Yeh the tomato juice is a trick I learned long ago. It has TONS of salt in it!

                be well,
                Lisa
                Knowledge is power ... Stay informed!
                YOU can make a difference - all you have to do is try!

                Dx age 12 current age 46 and counting!
                lost: 5 family members to HCM (SCD, Stroke, CHF)
                Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
                Therapy - ICD (implanted 97, 01, 04 and 11, medication
                Currently not obstructed
                Complications - unnecessary pacemaker and stroke (unrelated to each other)

                Comment


                • #23
                  Re: What meds are best for pre-syncope caused by obstruction

                  On the whole adding salt part I was told that to by my local cardiologist office the last time I was there because my BP was extremely low. It is normally low and the Verapamil and Isordil make it even lower 80/60. So I tried it and a week later I was in the hospital with CHF. I was dehydrated/retaining fluids go figure. As I was later told by my primary that it is not safe for anyone to add salt to the diet just to raise BP is there any truth to that?

                  Mary

                  Comment


                  • #24
                    Re: What meds are best for pre-syncope caused by obstruction

                    Again we are in that odd world of HCM and we tend to be the exception to many rules - -I have been on both high salt diets and months later on diuretics for fluid retention... it is a balance that is hard to find. Your body NEEDS salt---balance is the key!
                    Knowledge is power ... Stay informed!
                    YOU can make a difference - all you have to do is try!

                    Dx age 12 current age 46 and counting!
                    lost: 5 family members to HCM (SCD, Stroke, CHF)
                    Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
                    Therapy - ICD (implanted 97, 01, 04 and 11, medication
                    Currently not obstructed
                    Complications - unnecessary pacemaker and stroke (unrelated to each other)

                    Comment

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