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50M weak legs and fear after exertion, low resting HR
Hello. Sorry for my English, it is not my first language.
I am not asking for a diagnosis, only for similar experiences and ideas about what to discuss with my doctor or cardiologist.
Age: around 50
Sex: male
Height: 180 cm
Weight: about 90 kg
Smoking: non-smoker
Alcohol: I do not drink alcohol
Country: Latvia
Current medications: clopidogrel, rosuvastatin, nebivolol beta blocker, Triplixam, spironolactone, and pantoprazole.
Medical history: treated high blood pressure, cardiovascular risk, reflux and stomach problems. I have also had anxiety or autonomic type reactions in the past.
My usual blood pressure is around 111/79 to 120/80. My resting heart rate is often low, around 45–59 bpm, and sometimes around 40 bpm during sleep. I take a beta blocker.
Several times after physical effort, especially walking uphill, squatting, bending down, standing up, or doing physical work, I start feeling unwell after a while. My legs become weak or shaky, I get an urgent need to use the toilet, I feel inner fear or nervousness, pressure inside my body, and sometimes mild tingling around the lips or body.
After bicycle ergometry, I felt much worse after the test, even though during the test I felt mostly okay. The symptoms were similar but stronger: weak legs, inner fear, pressure inside the body like I was going to burst from inside, and itching sensations in the body.
I do not have chest pain, I do not faint, and I do not have severe shortness of breath.
Could this be related to a beta blocker or blood pressure medication, low heart rate, autonomic or vasovagal reaction, anxiety, dehydration, or stomach/reflux problems?
Has anyone experienced something similar? What tests, lifestyle changes, or doctor questions helped you?
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@nilsvega
That is a lot medications. Have you looked at the side effects of each medication? Asked your doctors if any of your medications are contributing to what you feel.
Your list of current medications: clopidogrel, rosuvastatin, nebivolol beta blocker, Triplixam, spironolactone, and pantoprazole.
To give an example. I was prescribed the spironolactone and got really sore nipple soreness, back pain. Told my HF doctor and said I was allergic to it and changed the medications. FYI: Those side affects were listed on the medications. After he changed my medication my symptoms went away (slowly though).
The statin can also make muscle weak and tiredness. Many times other medications can affect how statin is handled in the body making known side affects of statins be much worse.
Talk to your doctors. If not talk to a pharmacist and have them look at all your medications and then describe your symptoms to them. Many times a pharmacist can readily see contradictions in medications as that is their expertise.
Many medications can cause a low pulse rate. Look at your heart medications side affects. I know when I started Entresto and Carvedilol my heart rate when down into low 40s. I have a ICD/Pacemaker and we had to raise the pulsing to 70 bpm.
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3 ReactionsThank you for your reply.
I have been taking these medications for quite a long time, about 5 years. For most of that time everything seemed mostly okay, and my blood pressure became well controlled.
These symptoms feel like something newer. They seem to appear mostly after physical activity, walking uphill, squatting, bending down, or physical work. I get weak legs, an inner fear or nervous feeling, sometimes an urgent need to use the toilet, and a strange pressure sensation inside the body.
I am not planning to stop any medication by myself. I will discuss this with my doctor or cardiologist, and I may also ask a pharmacist to review all my medications for possible interactions or side effects.
Thank you for sharing your experience. It helps me understand what questions to ask my doctor.
@nilsvega
Have you had that test for vasovagal problems?
I would start there. If you have had Covid, that could be a side effect.
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1 Reaction@timely It sounds like you may have an undiagnosed structural problem in your heart (guessing, and I'm not a physician) such as a valvular problem. This might explain stress-induced bradycardia and possibly hypotension after a sustained effort. Again, this is a possibility that ought to be ruled out...definitively. Or, you have a form of dysautonomia that needs figuring out. Vagal tone could be what is at play here. There are treatments for that.
It may be time to rethink your beta-blocker. They work well for incipient hypertension, mild cases, but the body can develop an intolerance to them and experience bradycardia and the associated risks for fainting, falling, being short of breath, having swelling in the extremities, even fluid in the lungs. There are other ways to bust hypertension, not just beta-blockers.
I am worried about your GERD and your physical measurements. Are you charitably overweight? Your self-described statistics of height/weight suggest you may need to consider a regimen of weight loss, something slow and manageable that doesn't make you miserable or put you in greater danger of developing problems. You must maintain motivation, and that generally means a slower, methodical, regimen of weight loss, something that can be sustained indefinitely and eventually become a habit.