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Heart Disease (Expert Forum)
Atenolol usage
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Atenolol usage
by JAS1125, Jun 17, 2002 12:00AM
Doctor:
Some questions regarding atenolol and its usage. As a backround, my mother, age 73 had an episode of rapid beat arrhythmia in 1999. The EMT's gave her in injection to slow the beat---over 180-- and was admitted. Thallium stress test and echo-cardiogram were negative, and she was dischaged on atenolol, 25mg. Later in the same year, she had a minor stroke, and diagnostics were negative, and well as carotid check. In 2000, diagnosed with Parkinsons, so as you can see she's had an active history. Current meds are atenolol 25mg, requip 5.25 mg, wellbutrinSR 125mg, xanax .5mg 2x a day, plavix 75mg, lipitor 10 mg. Last week she had a follow up with family dr for blood work,and while there she had an ECG. She had taken her atenolol on empty stomach an hour and half prior to this--she usually takes with food, and did not know the ECG would be done. Her results were a beat of 46, and her doctor has her off the atenolol as he is concerned with her resting beat. She usually takes her pulse every day, first thing in the morning and throught out the day ,and it varies from 53-60. No shortness of breath or extreme fatigue. Would taking atenolol as she did cause her rate to drop? Also, is there another drug that can be substituted? My concern is that, considering her history of stroke, that she will be at increased risk for another episode, and that she needs some form of additional "protection". She has been off the drug for 2 days now, and rate is high 50's to low 60's. Any info that you can provide will be helpful in my upcoming discussion with her doctor. Thanks for your reply
Some questions regarding atenolol and its usage. As a backround, my mother, age 73 had an episode of rapid beat arrhythmia in 1999. The EMT's gave her in injection to slow the beat---over 180-- and was admitted. Thallium stress test and echo-cardiogram were negative, and she was dischaged on atenolol, 25mg. Later in the same year, she had a minor stroke, and diagnostics were negative, and well as carotid check. In 2000, diagnosed with Parkinsons, so as you can see she's had an active history. Current meds are atenolol 25mg, requip 5.25 mg, wellbutrinSR 125mg, xanax .5mg 2x a day, plavix 75mg, lipitor 10 mg. Last week she had a follow up with family dr for blood work,and while there she had an ECG. She had taken her atenolol on empty stomach an hour and half prior to this--she usually takes with food, and did not know the ECG would be done. Her results were a beat of 46, and her doctor has her off the atenolol as he is concerned with her resting beat. She usually takes her pulse every day, first thing in the morning and throught out the day ,and it varies from 53-60. No shortness of breath or extreme fatigue. Would taking atenolol as she did cause her rate to drop? Also, is there another drug that can be substituted? My concern is that, considering her history of stroke, that she will be at increased risk for another episode, and that she needs some form of additional "protection". She has been off the drug for 2 days now, and rate is high 50's to low 60's. Any info that you can provide will be helpful in my upcoming discussion with her doctor. Thanks for your reply
Doctor's Answer
by CCF-M.D.-RCJ, Jun 17, 2002 12:00AM
jas1125,
I'm sorry to hear the troubles you've had with your mother's health. A heart rate of 46 is getting fairly low, and certainly could be caused by the atenolol. The decision to stop the medicine hinges on a risk benefit analysis: What is the risk of your mother passing out or even dying from a low heart-rate versus the risk of a recurrent fast heart rate.
The answer to the question really depends on what type of tachyarrhythmia (fast heart rate) she had. If it was caused by atrial fibrillation (afib), then the tachyarrhythmia could indeed lead to recurrent stroke. Other tachyarrhythmias would be less associated with stroke. Other medicines are available to treat afib and prevent its recurrence, but the decision to use them needs to be made in conjunction with a cardiologist.
One thing to remember is that a person may have afib and stroke without the two being related. In fact, the sroke risk in afib patients is only about 5% per year if not treated with anticoagulation. An alternative strategy to treating your mother with heart medications, such as atenolol, would be to treat her with more aggressive blood thinners, such as warfarin. This decision would hinge on a separate risk/benefit analysis: what is the risk of your mother suffering from a bleeding complication versus the risk of stroke.
Good luck with your mother.
Hope that helps.
I'm sorry to hear the troubles you've had with your mother's health. A heart rate of 46 is getting fairly low, and certainly could be caused by the atenolol. The decision to stop the medicine hinges on a risk benefit analysis: What is the risk of your mother passing out or even dying from a low heart-rate versus the risk of a recurrent fast heart rate.
The answer to the question really depends on what type of tachyarrhythmia (fast heart rate) she had. If it was caused by atrial fibrillation (afib), then the tachyarrhythmia could indeed lead to recurrent stroke. Other tachyarrhythmias would be less associated with stroke. Other medicines are available to treat afib and prevent its recurrence, but the decision to use them needs to be made in conjunction with a cardiologist.
One thing to remember is that a person may have afib and stroke without the two being related. In fact, the sroke risk in afib patients is only about 5% per year if not treated with anticoagulation. An alternative strategy to treating your mother with heart medications, such as atenolol, would be to treat her with more aggressive blood thinners, such as warfarin. This decision would hinge on a separate risk/benefit analysis: what is the risk of your mother suffering from a bleeding complication versus the risk of stroke.
Good luck with your mother.
Hope that helps.
Thanks for the fat reply. The indications are that the arrhythmia was brought on by stress-related factors. At the time, she was under a lot of duress due to other non-related issues, and her dr felt that her system was flooded with adreneline, and caused the rapid beat. I'm not sure if it was atrial fib or not. She has not had a recurrence of it. Would 1/2 dose of the atenolol be helpful? thanks again
I've been told by my cardiologist that Heperin is a blood thinner and Warfarin is an anticoagulant.
Is there any wonder about the confusion and 'stylistic' differences out here in the 'heartland'.
I just spent the last week in the hospital and all I really accomplished is making some Doctors mad at me. I have all the symptoms of Lactose Intolirance but it has not been comfirmed as of yet.
I do know when I can keep my stomach under control (access acid and gas) I don't have any problems at all with my heart or breathing.
I have another condition that has me bent over and a fused spine and everything in my chest is already badly crowded. Any access gas causes my heart to flutter and if it is allowed to continue I go into AFib.
I have been dealing with the access acid and gas problem for over 40 years and it has always caused my heart to flutter but I never went into AFib untill 1999. I have always drank a lot of milk and consumed many other milk products.
No Doctor I have ever seen has even mentions Lactose Intolirance and from all the information I have been able to gather this could very easily be at the root of my AFib problems.
I am 63 years old and have smoked all my life and surley have at least some heart and lung damage. The last heart DR I saw was hell bent on doing open heart surgery on me even though two of the tests I took in the past few days shows no restrictions.
I feel this should be looked into a lot farther before we even consider surgery. I would like your comments on this situation.
Thank You art