low BP and increased heart rate in a Viral cardiomyopahy patient

[Antonio86]

Hello

I am 63 y/o male who was dx with Viral Cardiomyopathy in 11/09 . I was not able to tolerate the three medications I was on . On d/c from the hospital I was given HCTZ and coreg. I was on the two medicationd for 2 months and then off. My excercise tolerance was not good, if I would be walking up stairs I would become dizzy and with SOB no wheezing. I had an MRI of the heart that showed scaring but normal vessels and an EF of 42. I had a 48 hr holter that showed  PVC's and bouts of non sustained VT. There was concern that I should have a Defribillator however I declined for the time being. I have fainted one time in two years and It was a time I was rushing and had dinner with wine and a cigar and after dnner drinks.  My cardiologist asked me to go on Lisinopril starting on 2.5 mg to 5 mg to see how I do.
My BP with no meds was always 110/78  now with the 5mg of Lisinopril it is 82/63 ( started with the ACE- 5 days ago) with a rate rate of 98. My heart rate has been the same since my hospitalization.
I need to go up on the ACE to between 10mg and 20mg . I am not sure if I will tolerated the medication. I am afraid that my BP will continue to decrease. I am concerned but both cardiologists agree that I need to be on an ace inhibitor. Is it possible that after time my BP will become normal while on the ACE . My heart rate is still hight 98

Thank you

[Antonio86]

Hello

Thank you for your comments.  I was on coreg when I was in the  hospital and was discharged. I was on coreg for 2 months and then my Cardiologist took me off it. He tried Lisinopril while I was in the hospital however  the combo of  HCTZ and Coreg and the Ace inhib was causing me to feel dizzy and ill. Now it has been 8  months after my hospitalization and they are trying Lisinopril again. I am up to 5mg and my BP is 90/60 , I feel a little off balance. They want me on at least 10mg, 20 is better but with a PB of 80/60 I doubt I will be able to handle the low BP . I normal BP is 110/75   I have no DM. No hyperlipidemia and not HTN.  My EP doc feels that I should be with a Defribillator however I do not want one. It may be a mistake since I have PVC's at certain times during the day and night. I feel a little frustrated

[wineandroses]

I also had cardiomyopathy dx w/heart failure.  I think viral cardiomyopathy is a catch all when exact reason is unknown.  I was originally prescribed 50 mg. of Coreg and 40 mg. of Lisinopril.  Over the years I am down to 12.5 Corge and off Lisinopril although my left top half of my heart remains slightly enlarged.  The coreg normally lowers the HR.  My HR runs 48-50 BPM.  Coreg's purpose is to lower HR and help the heart squeeze more blood with each beat to keep the heart from wearing out so quickly.  How many mg. of Coreg are you taking?