CHF and lowish blood pressure

[Janeislay]

I was admitted to hospital a couple of years ago with a pulmonary oedema.  I did have an Xray, but no ECG or scan.  I was put on 8mg Perindopril : 80 mg Furosemide : 2.5 mg Bisoprolol fumaride : 75 mg Aspirin and sent home.

My blood pressure prior to that was never higher than 115 over 65.  It's now between 110/65 and 95/60.

While in hospital my saturation reading was on the low side, and they kept me on oxygen for a lot of the time.  Do I really have heart failure ?  And with my low blood pressure levels, do I really need an Ace Inhibitor and a Beta Blocker ?

I've had them reduced right down to 2 mg Perindopril, 20 mg Furosemide and 1.5 mg Bisoprolol - and feel exceedingly well.

Jane

[Janeislay]

Holy Mackerel !!  I'm well past the cut off age then, at 68.  That is diabolical !

I'm seeing the practice nurse mid March and somehow I'll make sure I get to see a Cardiologist on the mainland - or indeed a good Nutritionist, in whom I'd have more faith !

I do think my pulmonary oedema was largely brought on by the stress of a sick foal (I breed horses) and was a one-off.  Seems nonsense to be on three hypertension meds.

Thanks for your help.

[gmachris518]

Yes, I do live in the States, but my Primary did refer me to the Heart Clinic here, and I've never been without a cardiologist since that time.

Have you asked the nurse practitioner to refer you?  In the states they have the power to make a referral.  

It sounds like the medical where you are at, leaves a lot to be desired.  Do they also have a cutoff age for services, such as 59 years old?  They are trying to change the medical arena here in the States, and they are talking about cutting off any major medical for those over 59 years of age.  

Everyone here will be forced to buy into their health insurance, and if they don't, will be fined for failing to do so.  They also are planning to have counseling for anyone over the age of 59, about allowing themselves early death, instead of medical treatment, to make room for others who are younger and will go back to being a viable member of society.

The new medical guidelines in place for the new health coverage is several inches thick, and holds many nightmares for the people of the United States.  I am very glad that the balance of power has equalized since the last election, and I hope the new ones in power will stop the lunacy of the Powers that be in our country's head.

In any event, I would preasure the Nurse Prac to make a referral for you.  The heart is the center of life, so pushing for treatment should be a right, and I don't think it would matter where you are.

I surely do hope the best for you......

[Janeislay]

Thanks guys; I understand.  Maybe I shouldn't be stopping the Ace Inhibitor by myself, after all.

gmachris518 - do you mean I should find a private cardiologist ?  I thought your gp had to refer you - or are you in the States ?  cos that's different to how it works in the uK.

I live on an island in the South Hebrides - off the west coast of Scotland.

[jrbon]

Pulmonary edema is a very common complication of climbers, so if you go to a high mountain and get it, chances are that it is because the high. If you are in your hose and you have it, most probably reason is HF.

Yes, the explanation given is what cardiac remodeling means.

Jesus

[gmachris518]

I believe heart remodeling refers to enlargement of the chambers, right or left, or both.

I am on 3 BP meds, and have had BP of 54/34 within the last week.  I also have a defib/pacemaker, and as long as my pulse rate is at 60 or above the device doesn't do anything.

I dont' understand the problem with finding a cardilogist, as I have 3 who have changed my meds, and installed the defib into my chest, and they all work together in the same office. I am never without the services of a heart specialist.  Where are you at?

[Janeislay]

Thanks.  I'm afraid I don't know what you mean by "at least that you have had above 6000 m high".  What does this refer to ?

What is "heart remodeling" ?

Nice to hear of someone else with low blood pressure.

I don't have a doctor at the moment - no one has applied for the vacancy after my doc retired a year ago.  And I don't think the nurse can refer me - but in any case I have absolutely no faith in cardiologists.

The PIL clearly states that 8mg Perindopril should not be given in heart failure, yet that's what they gave me.

The practice nurse does take bloods every three months.

Thanks again
Jane

[jrbon]

I guess that they made the diagnose of HF based on your symptoms and because, at least that you have had above 6000 m high, the most common cause for pulmonary edema is HF.

Assuming that you have HF, you should know that, as fas as I know, the logic for the medication is NOT to lower the BP .

The Ace Inh. is prescribed to avoid heart remodeling.
The BB is prescribed to reduce the Heart rate and reduce the heart work.
The Diuretic is prescribed just to avoid another pulmonary edema.

Lowering BP is just an undesired side effect, in fact I cannot reach the doses of medication that are optimum for HF because if I do it, my BP gets too low (70/45 range)

If I were you, I will go to a cardiologist for evaluation of your HF that should include Blood test and cardiac echo to see your Ejection fraction and the dilatation of the heart. Then decide on the medication.

Of course you should not be on that medication without periodic controls.

Jesus