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Could my cardio version have caused an infarct?
Three weeks ago I had a cardio version for AFib. Aside from being slightly drowsy for a few hours after and having what felt like a bruised throat, probably from the esophageal imaging procedure immediately before, I felt fine. The bruised feeling lasted the better part of a week but other than that, I felt really good! Increased strength and energy. At my 3 week follow-up, which was scheduled with my cardiologist's nurse practitioner, I had an EKG. When I asked if I "passed" the test, I thought she seemed a bit evasive and answered "I am not allowed to give any results". I have found in my years (80) of life that nurses and techs typically will be willing to forgo that rule if the news is good. Yesterday (late Friday) I received online results that my EKG showed I'd had a septal wall infarct which was not present on the EKG done before the cardio version. While I understand that women often don't experience noticeable symptoms during a heart attack, it leaves me to wonder if the procedure caused the infarct. And, by the way, I know any procedure has risks. Any thoughts?
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An infarct is caused by thrombosis which, if you were dosed correctly with anti-coagulants, is extremely remotely possible...NOT impossible. We don't know if a previous clot formed and was somehow detached during the procedure or if it formed subsequently and caused the infarct.
Our hosts have this published on the www: https://www.mayoclinic.org/tests-procedures/cardioversion/about/pac-20385123
I have been on Eliquis 5mg twice daily since January (2023) when I was diagnosed with AFIB. When I was referred to a cardiologist it took a couple of months to get an appointment and another few weeks for the schedule to open up with room for my procedure. I was not asked to forgo my meds the day of the TEE-Cardioversion so I believe that I was properly dosed. In 2020 I had bowel surgeries and after one of them, developed a clot in my upper calf. I was put on Eliquis at that time for several weeks or maybe months but was allowed to discontinue them after the routine dosing period had ended. About a year later I was having a sensation in my other leg similar to what I remember having with the clot. I saw an internist who looked at and palpated my leg and said he didn't think I had another clot. However he didn't order any testing.
But back to the current issue, I was advised by my Cardio at my initial visit to monitor my BP because it was high when I saw him. I did so, and it was consistently high. When my readings were reported to my Primary doctor, he doubled 2 meds that I had been on for quite awhile... Lisinopril 20 mg and HCTZ 12.5 mg. So Lisinopril 40mg daily and HCT 25mg. After a couple of weeks on this regimen with no improvement, three days ago I began getting lower readings and the last ones have been quite low 116/65 is typical now. Sometimes I feel a little 'out of it' now, a bit weak and washed out. This is concerning to me, especially that it is happening on a holiday weekend. This evening I omitted the 2nd Lisinopril in hopes of evening things out until I can call my doctor tomorrow. I don't understand why the lowering of my BP seemed to be sudden after several weeks of increased meds.
Sorry, a lot of water under the bridge for me. I have no experience with anything other than anti-arrhythmic medications and the rate control medicine for hearts called metoprolol. My guess is that Lisinopril does something the same, which is to control heart rate and to reduce the force of each heart beat, which reduces heart pressure. I believe the initial test period for a drug meant to reduce BP is about three weeks to a month, and then adjustments are made. But, I don't really know.