Diastolic dysfunction and resulting a-fib

Thanks, @colleenyoung. Mayo has always been close to me. If you’re in Rochester, you’ll understand. I grew up in Decorah, 60 miles southeast. My mother died in St. Mary’s Hospital 20 years ago. My brother-in-law got his Pacemaker at Mayo. My brother died at Gunderson in LaCrosse while awaiting test results from the Mayo lab. On the positive side, family and friends always felt more secure, knowing that Mayo was an hour away. I feel the same way today way out here in Virginia. My favored hospital is Virginia Hospital Center in Arlington, a component of Mayo Clinic Care Network. So far, I haven’t had to be admitted there!

Martin

I owe everybody on this thread — especially @hopeful33250, @dawn_giacabazi, and @cynaburst — an update on my Diastolic Dysfunction after visiting with my cardiologist a few days ago. He told me A-fib is the very definition of DD, which is now a condition I probably can’t avoid, and after 2 years of it, I have learned to manage it. Since I have no tangible symptoms (other than a tendency to bleed from wounds, thanks to Coumadin therapy) he saw no reason for surgery and believes no medication would “cure” me. So management is the challenge, and he flatly stated that I need not fear trying a beta blocker in that effort. So my nephrologist prescribed carvedilol to bring my blood pressure down, starting with a minimal dose, possibly raising it over the next six weeks in hope of reaching a maximum positive (balanced) result.

Does this make sense to you? Do you have any suggestions for me based on your experience?

Thanks for the update @predictable. Given that you are about to start carvedilol (Coreg), you may want to read this thread started by @teatime http://mayocl.in/28YeSeN It includes a response by a Mayo Clinic pharmacist. @neeci and @teatime had to wean off the drug, but many use it successfully. We’ll be interested in your sharing your experience starting and finding your balanced dosage.

Martin: Thanks for the update. I wish you well as you pursue new treatments. I was not aware that DD and A-Fib were related, this will give me something to discuss with my cardiologist next month. My blood pressure tends to be low at times with a big gap between the diastolic and systolic numbers, perhaps that is related to the aortic insufficiency. I am planning on ordering that blood pressure monitor that has been discussed. I need to keep an accurate handle on what is happening. Please keep me posted on how your new med therapy is working for you.
Blessings,
Teresa

That does make sense. I also have diastolic dysfunction as a result of Hypertrophic Cardiomyopathy and I take a beta blocker and have for years. I do not have a fib, but beta blockers are a common medication for Afib as rate control is key.

http://mayoresearch.mayo.edu/center-for-individualized-medicine/pharmacogenomics.asp

Thanks for the reminder, @dawn_giacabazi. I want to finish preparing a request to my cardiologist, nephrologist, and urologist for approval of some pharmacogenomics (PGx) tests to see whether any of them — or my HMO — is prepared to add them to their protocols for a range of diseases. I’ll submit the first such request in about 2 weeks.

Martin

Teresa, I pursued the DD and A-fib link after seeing some research from Mayo suggesting that beta blockers could produce adverse effects in some more serious DD cases. It turns out that the threat of this is rare — not for those of us who have DD as a result of A-fib, according to my cardiologist, but in cases where there is moderate to serious DD but no A-fib. So he gave the green light for me to take Carvedilol.

Martin

You are welcome. Remember these particular test is not for diseases. This is to help determine the exact medications to treat you at the right drug, at the right dose & the right time to prevent over dose and drug interactions. To also help prevent diseases like liver & kidndy failure from taking wrong medications. 🙂

Yes, I should have said “for a range of therapies” rather than diseases, right?