Pulse rate and fatigue

[sciman]

My pulse rate is about 52 due to exercise and taking 12.5mg of metropolol daily. I take this medication for a mild cardiomyopathy (46%). Lately I've felt more fatigued and a little light headed. These symptoms seem to diminish if I'm just sitting or exercising. I am wondering if my pulse rate is simply too low, especially when combined with my low ejection fraction. My cardiologist's nurse informed me that it wasn't and that it probably wasn't the cause of my symptoms. She thinks it is more a side effect of the metropolol. I talked to a cardiologist friend who said the same thing and that the dose was so low it might not be worth taking it if it's causing problems. He also thinks that exercise is simply masking my symptoms with endorphins and the increased pulse rate doesn't have anything to do with me feeling better. So I'm wondering if there is a BP medication for cardiomyopathy that can lower BP without lowering my pulse.

[banglamom]

I'm sort of at the same spot as you, but a bit different.  I have a mild cardiomyopathy but huge conduction problems.  I take the meds to get my RATE down and have to deal with what it does to my PRESSURE.  Most all these meds do both.  You could get a pacer to support the rhythms on the low end.  Mine is awesome and I honestly recommend getting a pacemaker.  My pacer maanages the rhythms but I can still get sick, weak, dizzy hypotensive.  Good luck finding the magical balance for you.  By the wat, IF they can fix it with an ablation, go down that road.  I would do it again (for the 4th time) if he thought he had a prayer at fixing it.  Keep us updated.

[jimgreg]

i have a low heart rate at night only..during the day its about 75..i was on this med that ur taking i think the brand name is loppser..it takes ur pulse down..its a beta blocker..this  is a blood pressure medicine..its actions are to relax the walls of the main arteries..then for ur bp goes down!! but it also relaxes the heart so its not over doing its self..someone with a low heart rate should never be on this kinda blood p meds..i was on it for 2 yrs..i never felt like passing out or anything..i  took my blood p one day it was ok..but the heart rate was real low 42..so now im on lisinopril 40mgs aday..(ace inhibitor)..  THIS MEDICINE LOWERS BLOOD PRESSURE AND HEART RATE..YOU MIGHT WANT TO TALK WITH UR CADEOLIGIST!!!  GOOD LUCK TOO YOU FRIEND..JAMES

[Jerry_NJ]

I must assume you HR of 52 is at rest, not when exercising.  Even that being the case, it is an unusually low rate.  The BP is rather low too.

Finally I consider 12.5 mg Metoprolol to be such a low dose I've never heard of it, I take 100 mg a day myself, but then I have a rest HR around 100 or more without it.

We don't have your history, or I've overlooked it.  If the HR and BP is your long term normal and what you had prior to the 12.5 mg Metoprolol , then maybe it is causing fatigue. I think it is one of the possible side effects, and when I've taken 200 mg of Metoprolol a day, I fatigue and dizziness problems.  So, it can do it to me at high dose levels.

[sciman]

Thanks for your input, I'll check into that oximeter. My BP is typically 125/69, so not low enough to warrant fatigue/lightheadness.

[caregiver222]

The pulse rate, without knowing the blood pressure, is a meaningless number. Yes, 52 is oow, even for someone who exercises frequently. Again, what is rhythym and what does the EKG show. You need to purchase an inexpensive pulse oximeter, which have come way down in price. These slip over your finger and provide a real time number telling you how much oxygen is in the blood. If the sympoms diminish while sitting or exercising it might be a failure of the peripheral vasculature to compensate. Yoy need to get your orthostatic vital signs evaluated. As far as suggesting the exercise doesn't have anything to do with you feeling better, I disagree. There are several possible etiologies, so let's think like Dr. House, but not take the Vocodin. I like to listen to a person with medical problems very carefully.

"The lightheadedness disappears when I exercise..."

Now if the problem was cardiogenic, with increased oxygen demand the light-hedness should get worse.

But let's aknowledge every leg contains about a liter of good old blood. If the vasculature is relaxed, this increases body capacitance, and diminished the blood supply to the brain. When you walk, or run the muscles in the calf and thighs contract, compressing those blood vessels and acting an an auxiliarly heart pump, providing increased oxygeneation to the brain.

I'm not going to provide advice on your medications for treating heart problems because they will track me down and put me on the chain gang, however if I were writing a novel I might have the character ask a physician with naturopathic inclinations what they thought of Omega-3 supplements, alpha-lipoic acid, and specifically taking magnesium supplements, in a dose prescribed by the physician.

Good luck.