I wrote about being diagnosed with atrial fibrillation (afib) in My Carcinoid Heart about a month ago. I saw my primary care physician a few days after that. He referred me to a cardiologist and also felt that my blood pressure may be “over-medicated”, so he took me off my high blood pressure medicine. Two days ago, I had an echocardiogram. Today I met with the cardiologist.
The cardiologist and I discussed my symptoms of lightheadedness and shortness of breath. He believes the shortness of breath and the lightheadedness are symptoms of the afib, not the carcinoid tumor and not my being out of shape. The lightheadedness is also a side effect of four of the medications that I take, so he thinks it was a good idea to take me off the high blood pressure medicine. My blood pressure was only mildly elevated when we met. I have had only a couple of minor episodes of lightheadedness since stopping the medicine.
Currently, I am to continue to take one baby aspirin a day and to work at staying well hydrated with electrolytes like gatorade or other sports drinks. I can continue my exercise although in the future we may have to limit strenuous bike rides, not yet though. When Laurie and I return from Hawaii in early June (Woo Hoo!!!), I will have to wear a continuous heart monitor for a couple of weeks to measure my heart rate and arrhythmia anytime that I get lightheaded.
If the heart monitor shows more problems than he suspects, we may have to talk about blood thinners or a pacemaker. Ironically, other drugs for afib are used when your heart beats too fast. Mine beats slower than most people’s and sometimes too slow, so, in worst case it would be the pacemaker.
On the plus side, he saw no sign of the heart valve deformity that can be caused by carcinoid. About 25% of carcinoids die of heart failure and a number of carcinoids must have their heart valves replaced with artificial valves. I am thankful that we are not looking at that, at least for now.
He told me something that I would never have guessed. Endurance athletes like distance runners and bicyclists (me?) have afib more often than the ordinary population. Who would have guessed that training to be healthy and athletic can have such a dangerous side effect?
The net of all this is that I have atrial fibrillation. Current treatment is baby aspirin and careful hydration. Final treatment decision to be determined.