Increased fatigue and breathlessness

Hi all,

Long time lurker - first time poster! I'll try to make this post as succinct as possible, but if you need any more info please ask!

I'm a 67 year old lady who had an ICD/PM implanted in December 2013. I was diagnosed with cardiomyopathy of uncertain aetiology and paroxysmal atrial fibrillation. If it's of any relevance my ejection fraction has now normalised. For info, I'm taking the following medication: Amiodarone 200mg; Atorvastatin 10mg; Bisoprolol 5mg; Furosemide 40mg; Irbesartan 75mg; Warfarin.

The two issues I have are a hacking dry cough which started in mid-2014. Switching from Ramipril to Irbesartan improved things significantly, but the cough never disappeared completely and it’s got worse over the last couple of months. Interestingly, Co-codamol effervescent tablets provide very good relief for the cough. Secondly, I get fatigued quite easily - my energy levels/stamina never returned to normal after I had the ICD/PM, but it seems to have got worse over the last few months. Doing household chores and walking short distances leaves me tired and out of breath and more often than not get flank pain on one side of my back.

My cardiologist has offered an AF ablation which I’ve accepted as it may improve my quality of life. I’m also having a stress echocardiogram in the next couple of days because of the increased fatigue and breathlessness, followed by a consultation with my cardiologist.

I’m just wondering whether there’s anything I should point out e.g. does my medication need to be looked at or does my device need tweaking???

Any advice would be much appreciated!

2 Comments

What a cocktail of drugs !

by IAN MC - 2015-12-30 02:12:00

Hi ena Glad you've moved on from the lurking stage !

You have mentioned 6 drugs which you are taking regularly and you have added Co-codamol to the mix so that makes 7 . Without doubt such a cocktail of drugs is highly likely to impair your quality of life . Hopefully a successful ablation could help you cut down on the drugs.

It is interesting that clinical trials are never done to find out any long term problems from polypharmacy (drug combinations) so every patient is a guinea pig to some extent. Ask your Dr what studies have been done to see the effects of the 6 drugs he has prescribed in combination ; if his answer is not " None " then he is lying or mis-informed

You were right to stop the ace-inhibitor, lisinopril, as it is a very common cause of dry cough BUT at least 4 of the drugs you are taking now can also cause a cough ( amiodarone, bisoprolol, irbesartan and furosemide ) Almost all of them are documented as possible causes of fatigue and breathlessness so the fact that you are experiencing this is not surprising.

But your atrial fibrillation will also be the cause of some of your problems so I guess you are caught between a rock and a hard place.

If I were you I would ask your Dr :-

- Do I really need take every one of those 6 drugs ? ( accepting that the blood-thinner is non-negotiable with your medical history )

- What would happen if you removed or substituted one at a time ? Would my quality of life improve ?

- If this fails, how quickly can I have an ablation ?

Best of luck

Ian

Cough-variant asthma

by Bodnik - 2015-12-31 03:12:01

I had same exact same symptoms beginning late spring this year. After 5 mths went to lung MD. MD gave me an inhaler. Within 24 hours could breathe after activity, energy level increase, coughing eased. After about 10 days cough gone. That's the good news. Bad news was Doc determined I had fluid on lungs which has started a whole new set of issues.

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