Afib and high diastolic value

Posted by andreeag15 @andreeag15, May 18 2:08am

Hello,
My dad is 70 years old and started to complain about heartburns starting from the chest area going all the way to his head leading into blurred vision and headaches.
We went to a neurologist, did an MRI nothing was wrong there. He recommended to see a cardiologist as my dad was found with high BP (16) too.

The cardiologist confirmed the high BP, asked my dad to take Atacand, Aspenter and Sortis plus to do some blood tests. Results: all tests were good except the high cholesterol level, potassium and increased TSH level.

Following the EKG holter and blood pressure holter his treatment was changed to Eliquis 5mg x 2/day, Sortis and Detralex.

We are constantly monitoring his heart rate and I’m concerned about the very high and low pulse rates plus the high diastolic value (10). Is this diastolic value a concern?

Thursday:
7:00 14/7
10:12 9/8 pulse 159 (dizziness)
10:30 123/88 pulse 146 (after meds)
14:00 10/9 pulse 118
15:30 13/8 pulse 59 (after sleeping)
21:30 11/8 pulse 71
22:00 12/9 pulse 55 (after meds)
23:00 11/8 pulse 57
23:30 12/8 pulse 55

Friday:
10:00 13/10 pulse 54 (after meds)
13:40 12/10 pulse 138
16:00 12/10 pulse 84
20:00 12/11 pulse 155
22:00 14/10 pulse 46
22:40 13/10 pulse 57 (after meds)

Saturday:
6:30 15/10 pulse 58
10:00 144/96 pulse 64

We are still waiting to see an endocrinologist and a specialist in sleep apnea next week. Until then I am concerned if he’s going to be ok this weekend until we get to see a doctor.
Thank you!

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Is he in afib most of the time?

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@windyshores

Is he in afib most of the time?

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Hi @windyshores Afib has not yet been confirmed but it’s very likely that he has this. In terms of frequency, I guess judging by the heart rate values I’ve shared it’s up and down throughout the day.
The only symptom my dad has is dizziness (probably correlated with episodes of low blood pressure). When his BP is high he feels ok.

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@andreeag15

Hi @windyshores Afib has not yet been confirmed but it’s very likely that he has this. In terms of frequency, I guess judging by the heart rate values I’ve shared it’s up and down throughout the day.
The only symptom my dad has is dizziness (probably correlated with episodes of low blood pressure). When his BP is high he feels ok.

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Can he get a Kardia device ( 1 lead is $79) or a smartwatch?

When I am in afib my heart rate jumps around like that and so does my blood pressure. So I wondered if he is in afib a lot of the time.

Did the cardiologist inform him he was on Eliquis now due to afib? Sounds like there was afib found on the monitor. What percent of the time , I wonder.

I get very light-headed with afib. I also have low bp. I am sorry he is going through this. Is he going to see an electrophysiologist who might consider an ablation?

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@windyshores

Can he get a Kardia device ( 1 lead is $79) or a smartwatch?

When I am in afib my heart rate jumps around like that and so does my blood pressure. So I wondered if he is in afib a lot of the time.

Did the cardiologist inform him he was on Eliquis now due to afib? Sounds like there was afib found on the monitor. What percent of the time , I wonder.

I get very light-headed with afib. I also have low bp. I am sorry he is going through this. Is he going to see an electrophysiologist who might consider an ablation?

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Thank you @windyshores for your quick response.
I will look into ordering a Kardia device as you suggested.

The cardiologist did not specifically mentioned Afib, but definitely saw some irregularities in his 2 holter readings, therefore Eliquis was the new med introduced (for a sec we thought that he feels dizzy because of this med). She recommended to see an arrhythmology specialist and an endocrinologist (high TSH) ASAP.
In the meantime (also being weekend) I am concerned if these BP values and symptoms are a major concern or if he will be ok until we get an appointment possibly next week to look into it?

Are these variations in BP from 144/96 to 120/100 normal? I understand you have similar ups and downs.

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@andreeag15

Thank you @windyshores for your quick response.
I will look into ordering a Kardia device as you suggested.

The cardiologist did not specifically mentioned Afib, but definitely saw some irregularities in his 2 holter readings, therefore Eliquis was the new med introduced (for a sec we thought that he feels dizzy because of this med). She recommended to see an arrhythmology specialist and an endocrinologist (high TSH) ASAP.
In the meantime (also being weekend) I am concerned if these BP values and symptoms are a major concern or if he will be ok until we get an appointment possibly next week to look into it?

Are these variations in BP from 144/96 to 120/100 normal? I understand you have similar ups and downs.

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@andreaag15 I can only say that I feel safe 🙂 The electrophysiologist is an expert in arrythmia.

If the TSH is high, then thyroid function is low, according to what is online and my doc. So that would not speed up the heart. But he would need to be careful with thyroid meds I would think, so that function doesn't go too high. I took my daughter's low dose supplement by mistake (long story) and my heart went crazy!

Maybe someone else knows more about this combo of issues and will chime in.

Electrophysiologist (EP) and endo can work together, hopefully.

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I am 75 and was diagnosed with AFib 8 months ago. The trigger was my TSH level. Was treated for hypothyroidism for 25 years and then it went very low (meaning it changed to hyperthyroidism and my med had to be reduced).
Your dad's thyroid may need to be checked fairly often until it gets stabilized. I have seen an endocrinologist for many years and he has been checking my TSH every 2-3 mo. (TSH levels do not typically change very fast).

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'...Are these variations in BP from 144/96 to 120/100 normal? I understand you have similar ups and downs...'

Yes, they are normal. You can be at rest and have surprising rises in both heart rate (HR) and blood pressure (BP) simply by bending over to tie your shoes, particularly if you are carrying a little more butter than you ought. Similarly, standing from seated will do this, and if you walk any distance, those rates are likely to be sustained throughout the effort.

I take my BP when I awaken one or two mornings a week. I wear a Galaxy 4 smart watch that has a BP function. The watch must be calibrated with a proper cuff once every 28 days, a bit of a pain, but I think the health authorities in Canada wanted Samsung to have this provision due to the novelty of the technology and not wanting to rely too heavily on Samsung's research data. But, my own BP is always quite low when I do this quietly upon waking. Yet, the rest of the day might scare me, so I never bother. There's simply too much variability and different demands on my heart from hour-to-hour.

What you want is an average over many days where the diastolic is above 80 consistently, then there is cause for concern. Maybe something as simple as metoprolol. But if there is another pathology or disorder, then the matter can usually be corrected.

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I wonder if monitoring too much is an issue. I would monitor heart rhythm when he is symptomatic, but maybe not heart rate or blood pressure so often 🙂 If he does have afib, he is safe on the Eliquis.

Low thyroid function can cause a slow heart rate. I have no idea if that is relevant but glad he is seeing an endo.
https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284

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Good point....as you may have read about my episode in the ER checking my Galaxy watch every two minutes to see what my HR was. My wife finally held out her hand and demanded the watch.

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Yes, I’ve also been told by one of my cardiologist team to stop monitoring so frequently when I get aberrant readings as it can cause anxiety which can exacerbate symptoms. But it’s a normal reaction to want to monitor when things are out of the normal range.

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