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Metoprolol ER

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Karen 54 Find out more about Karen 54
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  • Metoprolol ER

    How low is too low for BP when on Metoprolol ER. My BP has been running 92/67 with pulse 58. I have been on the med for almost a week and taking 50MG

  • #2
    Hi Karen,
    Those values would be on the low end of normal resting BP and HR is fine.....However, what is more important would be how you feel and how you respond to exercise and activity.....Do you get light headed frequently? Or do you feel very fatigued with normal activity? What are your BP and pulse after some activity? .... they both should increase slightly... If you have concerns check with your doctor.
    After years of symptoms:
    Officially Diagnosed HOCM 2006
    Myectomy 3/11/13 at non-COE
    Extended Myectomy 7/23/14
    At Mayo with Dr. Joseph Dearani

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    • #3
      Today when I took a walk my heart rate got up to 99 and that highest point. The medicine makes me real tired. When I walked up a small incline while walking I got light headed.

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      • #4
        Hi Karen, Yes, the class of drugs called " Beta Blockers" ...like metoprolol, can make you feel tired. Sometimes it is just for the first few weeks or months until your body is used to them..... sometimes it does not go away and you need to talk to your doctor about it. If it continues the doctor could possibly reduce the dose or change the medication.
        The most important thing is for you to understand your diagnosis.....which you haven't stated, but I assume is HCM since you are on the HCMA forum. Once you understand the dynamics of what is going on in your heart, then you can have good discussions with your cardiologist about your symptoms and treatment. One of the main reasons for medications in HCM is to relieve symptoms that interfere with your life.....not make your life worse.
        You might very well benefit by calling the HCMA office and getting an appointment to talk to someone about your case. Also, if you belong to Facebook there is an HCMA Facebook group that offers a lot of information.
        After years of symptoms:
        Officially Diagnosed HOCM 2006
        Myectomy 3/11/13 at non-COE
        Extended Myectomy 7/23/14
        At Mayo with Dr. Joseph Dearani

        Comment


        • #5
          I've had HCM for a long time, essentially onset when I was 19 (1991) in the military. I was first in the family ever diagnosed. Since then, 2 of my 3 siblings have also been diagnosed. I didn't start medication until about 2007. I was on Verapamil until about 2011 when my heartbeat went drastically high (about 130 at rest, watching TV while wearing a halter monitor for 2 or 3 weeks). They switched me to Metoprolol Tartrate then.

          My energy levels have steadily decreased over the years. I managed to lose some weight (56 pounds) in 2015 by walking and better diet, but my energy was really zapped. I mentioned to my PCP that maybe my HCM was causing my energy levels because things weren't nearly as good as they used to be. I would also feel like I was going to pass out when I sneezed. I didn't mention that to PCP, but my wife mentioned it to my cardiologist during a visit and he became more concerned about my HCM then. I'd just had a nuclear stress test (February, 2018 - no blockages detected), so he set me up for another echo. My last echo was either 2011 or 2012 and my septal wall was 19 mm. The one they did in March showed it at 30 mm. They sent me to another hospital for potentially have a septal myectomy who did their own echo, this time with contrast, about 3 weeks later. They measured the septal wall at 33 mm and opted to do the surgery. That was completed in June, 2018.

          However, I'm still exhausted with pretty much every activity. Most of the time, I can walk 5-10 minutes and need a break to catch my breath/find a second wind. Sometimes, I can walk 15-20 minutes and not want to take a break. Stairs are another story. I have a 3 story house (main level, upstairs, and basement). The stairs to each level have a landing. Nearly every time I go up the stairs, I stop at the landing for 20 or so seconds, breath a few times to catch my breath, then finish the stairs. I get winded taking a shower. Come on, life, I'm just taking a shower! Then I read a few posts on this board and came across this post as well. In another post, someone stated that their beta blocker & statin zapped their energy. I have always thought it was my HCM zapping my energy, but they may be on to something. Since I had the myectomy, my dosage was increased (from 50 mg twice a day - they were somewhat concerned with my low BP readings to increase it to 75 mg twice a day, so halved the 3rd pill).

          In addition to a statin (40 mg once a day), i'm taking 62.5 mg of Metoprolol twice a day. Normally, when I hear my phone reminders and take my medicine as I should, my BP at rest is about 100/60. If I've been exercising well enough (3-7x a week, walking 15-30 minutes each time), my at rest temp can be lower. Sometimes, much lower. My lowest captured on my home device have been 74/42 with 83 bpm, 82/45 with 57 bpm, 81/47 with 61 bpm, 78/46 with 65 bpm (I took screenshots to show my cardiologist). He has been only a little concerned, given the medications. Also, in their environments, it's never been that low. I have tested with another unit here (bought a 2nd one) and at my sisters and all 3 are pretty close. So obviously I do have some anxiety that bumps up my BP when I see them in their offices. Additionally, for the last 3 or 4 years, I can tell when it gets that low as I've learned it's also a trigger/sign of an oncoming ocular migraine. Both eyes start really slow with a faint flashy light like I'm standing in a dark room and focused on a strobe light that I can't not look at, but it slowly intensifies until I pretty much can't see/focus on anything and I have to give it 20-30 minutes to subside. The only blessing is it usually doesn't come with pain like regular migraines. It does incapacitate me until it's over, though. I have also learned then, that if I chug down a bottle of water, that usually helps speed up recovery. I am not sure why, I drink enough water, coffee, soda, etc. to know I am not dehydrated.

          My doctor did suggest talking to the surgeons again (not seeing much relief energy wise) and potentially having a second surgery. I really don't like that prospect, but it may have to happen. I really need to try real hard to lose more weight and see if that can help first as the surgery recovery was really rough. I can't imagine doing it again right now (I'm a little heavier than pre-surgery weight, maybe 10 pounds heavier).

          At any rate, there is a lot of good information on this site and I'm sure I'll be reading here & there for weeks when time permits. I did want to respond here and not really make this 'about me' but show my BP readings and what my doc had thought. Obviously, the posts are months old now and you likely have your answers, but the next person that finds this might like more info to read also.

          Comment


          • #6
            Dear Bluwolf..... Welcome to the HCMA forum. It sounds to me like your medical management could and should be tweaked based on your current symptoms. The truth is many Cardiologists and even cardiac surgeons say they treat HCM but they are not up to date on trends, skills, and surgical techniques that HCM Centers of Excellence have used and proven by managing hundreds of cases each year. Your Cardiologist may only have a dozen HCM patients and only one that is as severe as you.
            PLEASE do not consider a second surgery without going to a Center of Excellence for evaluation. Was your myectomy done at a local hospital? Or an HCM Center?
            Usually after a good, aggressive surgical myectomy your medications can be reduced....possibly you could ask your cardiologist if you could try reducing your beta blocker.? But again an evaluation at an HCM center of Excellence will give you a treatment plan medical and or surgical andwork with your local cardiologist.
            I think you could benefit from calling the HCMA office and speaking to Lisa about your case before you move forward. Also, this forum is fairly quiet but there is a very active HCMA Facebook group you can join.
            I personally went through having an inadequate myectomy done locally not providing relief of my symptoms, I also found that medications like metoprolol caused severe fatigue in my case and changed medications. You are a young man, properly managed HCM does not need to be like this.....Also, a small aside....Have a blood test for anemia. Often after open heart surgery your blood count can be low and you need iron supplementation.....many aspects can contribute to your symptoms at this point...you need an HCM expert to value your complaints and sort through them with you.
            Last edited by JillC; 12-27-2018, 11:32 AM.
            After years of symptoms:
            Officially Diagnosed HOCM 2006
            Myectomy 3/11/13 at non-COE
            Extended Myectomy 7/23/14
            At Mayo with Dr. Joseph Dearani

            Comment

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