Recent Right and Left Heart Catheterization

Did the gray-outs happen after you began taking the metoprolol, or had you low BP issues previously and had some of those episodes earlier?

Metoprolol acts in two ways: it slows the heart and it makes its contractions less forceful. It is the latter characteristic that makes it sometimes useful for incipient hypertension. Unfortunately, in some people, even a low does can set the heart on it's proverbial backside and put it into severe bradycardia, meaning below 45 BPM, well below the technical upper limit for bradycardia of 59 BPM. In case that is confusing, the official upper limit for bradycardia is 59 BPM. It should be obvious that many fit and healthy adults, especially men, will have decent blood pressure at rates as low as about 45 BPM seated and calm. But some/most women, and those who are on metoprolol with its effect of also making the heart beast less forcefully, may find that it's simply too low and they get balance, vision, and vestibular problems that cause them to feel faint, get dizzy, get short of breath, feel like they're going to faint, and even hearing can be dulled as well as that gray-out in the eyes.

So, this is something you definitely want to impress upon your electrophysiologist or cardiologist.

As for whether treating your stenoses with only a statin, I'm not an expert and can't give you any advice on that account. Statins are not magic, and they can bring on their own nasty side-effects. Not only that, but the most optimistic research on their efficacy says that something like 300 patients need to take it for ten years for one of them to avoid a heart attack due to ischemia. You can look up the facts for yourself, but they're not terrible convincing. Lifestyle changes will possibly have to be quite severe in order to overcome your habits, if they've been poor and worked against you all these years, .......OR.....to overcome what may be heritable hypercholesterolemia. IOW, your genetics may be your own worst enemy. Statins might be the only reasonable recourse if this is the case. You can be tested for genes that are likely to raise your cholesterol levels into dangerous territory routinely.

Again, I'm not trained in medicine. I understand the nature of your circumstances and your very reasonable questions about just popping pills and hoping for the best. It turns out that most cardiac surgeons won't operate until a stenosed vessel approaches 70% blockage. You're there, apparently.

This is where you'd think very seriously why you wouldn't opt for a second opinion.

Thank you for your comments. I will discuss this with my cardiologist during my follow-up appointment in a couple of weeks.

Ask about Rapatha. Metoprolol and Isosorbide don’t fix blockages.