New Med For Chest Pain (verapamil)-side Effects

[mkoven]

So in another attempt to stop my night-time chest pain episodes, we are trying me on a new drug-- a calcium-channel blocker called verapamil. This is going along with the theory that it might be some form of prinzmetal angina or overconstriciton of arteries. (I've posted about these episodes before. They always happen between 1am and 7am, after I've gone back to bed after using the bathroom. they are more likely if I lie on my back than my side, esp. left side.) The doc tried me first on propranolol, in case these episodes were triggered by an adrenaline surge with all the sudden changes in hr and bp when I go from lying to standing to lying, but I had shortness of breath, so he said no to beta blockers.

anyway, verapamil is supposed to slow heart rate and dilate vessels, in this case to prevent spasm. He started me on half a pill of the smallest dose, so 20mgs a night, only at night. I think I'm not a happy camper. It seems to stay in my system for 12 hours, so I feel more weak and lightheaded when I get up. But worse, it seems to make it hard to breathe at night too, for different reasons than the propranolol. I can inhale fine (with propranolol, couldn't), I just feel like I can't get my air-intake to match my needs, so I"m always on tehverge of hyperventilating. And, with this strange positional component, it's worst on my left side, second worst on my right side, best on my back. I took my bp and it wasn't too bad (though who knows when I'm sleeping)- anywhere from 100/53 to 125/65, heart rate between 56 and 63. But it feels really wrong.

I feel a little of the breath issue now that I'm awake and the drug is still in my system, even upright.

even though the drug is supposed to slow hr, for me it feels like it makes mine faster, but when I take my pulse it is relatively low-- so maybe it's just pounding differently from what I"m used to , so I recognize it?

so part of me thinks this is part of the drug vasodilating me? If it is a spasm, that type of drug is indicated.

What do you think? I'll call the doc and tell him--it's been 3 nights. My proposal would be to go without tonight and see if I feel "normal." My spouse is out-of-town, so I won't want to start anything new till he gets back, in case I have a really weird reaction to something new...

[EarthMother]

I did verapamil for years when I was in my early twenties (circa 1985). This was way before they knew about POTS I just had "tachycardia on mild excertion" back then. ;-)

I also had chest pains and adrenaline surges so msybe that's why they tried it. Can't say it ever made me feel better.

I stopped taking it after the birth of my first child in 88'. Subsequently changed doctors and none of my cardiologists since wanted me back on drugs.

Turned out for me the chest pains (which did last years) were likely NCCP (non-cardiac chest pain) and once I got my spastic colon (this was before they called it IBS) under control the chest pains stopped as well.

Good luck finding something that works for you and may you sleep well soon.

~EM

[delphicdragon]

Strange thought, mkoven, could the chest pain be purely positional as well? I have ehlers-danlos, and though a distinct heart murmur is heard when I am upright, no such murmur can be detected on Echo, as they are done lying down. You may have the exact opposite. I get severe chest pain if I am up too long- you may be getting these pains when you are laying down too long and then stand up, forcing your heart to move into a new position. I look at it this way, if all my collagen is disorganized, and there is collagen in the heart, that too can get overstretched or move in ways that it shouldn't. Just a thought.

Sara

[mkoven]

In rare people, I read, calcium channel blockers can cause congestive heart failure. According to the bejillion tests I've had, I don't think this is my case, but maybe the drug did transiently affect how my heart pumps??? Apparently chf patients feel worse lying on their right side, so maybe lying on that side does affect how your heart manages pumping blood??? Once the drug was out of my system, about twelve hours after taking, I felt back to normal. Haven't heard back from doctor, but I won't take it again tonight. My spouse is out of town, and I hate being alone when I'm having weirdo symptoms and reactions. Hope I have an uneventful night. i wish I could react to meds less dramatically. I guess I handle midodrine, florinef, and my allergy meds okay--so it's not all drugs. but the list goes on...

[bjt22]

Well, is this drug helping with the night time chest pain? That would be the question. If it seems to help, then are the side effects worth the relief from the chest pain? Side effects often lessen over time. While you might feel a bit loopy at this point, in a few weeks, this might well improve.

If the drug doesn't work, then what's the point?

I still have chest pain, but mine is lessened by a beta blocker and catapres. Looking back, I did have side effects to the beta blocker for awhile, but they did diminish over time. I still have bouts of the chest pain you describe, but they aren't nightly occurrences.

[mkoven]

Well I talked to the doctor, and no more verapamil. He wants to think more about the next step. He thinks my vagal response kicks in too fast after I lie down, which triggers an adrenaline surge, which triggers chest pain. But fears that anything that increases the vagal response (like relaxing my arteries with verapamil) could just trigger a bigger surge.

But not sure where this leaves me, till we come up with something new to try.

and I did have another night time chest pain episode last night.

Anyone know how one can know for sure that the heart hasn't sustained damage, esp. if I don't go in for ekg/ cardiac enzymes every %$#! time this happens?