Herceptin Heart Attack

My cardiologist sees me every month since the Herceptin was stopped.  I alternate between him and his nurse practitioner.  The reason I go so often is after the Herceptin was stopped, he put me on Coreg which is a beta blocker. Every month he wants to double the dose if I can handle it.  I started at 3.25mg 2x per day.  I am now at 6.5mg 2x per day.  I go again tomorrow expecting to go up to 13mg 2x per day.  He said that he is hoping I can handle up to 25mg on that same schedule.  His comments were that studies show that the more Coreg you can handle, the greater potential for recovering a portion of the function - some do and some don't.  I am only 39 years old, so maybe that has something to do with it.  My EVF dropped from 70 to 45 after 6 months of Herceptin.

I must have a cardiologist not in the know.  They started me on 6.25 mg, twice a day of the COREG but no discussion of increasing it but maybe because I started at a higher dose.  Go figure. 

My cardiologist has said nothing about increasing beta blockers, putting me on coreg.  He said he thinks a lot of the tests may be just "noise."  I still do not have the energy I used to walking up hills etc so I think the changes might be real, I just hope not permanent.  Thank you for all the other posts cause I am now going to ask him about Coreg.  The hard part of all this is not knowing what to ask about -that is why this discussion group is also valuable.  We can really share and learn from each other.  Thank you everyone.

After reading your post, it suddenly hit me that my fatigue might be due to the beta blocker and ace inhibitor that have been added.  I fall asleep way too early in the evening and sometimes feel like taking a nap during the day which I can not afford to do.  How do people know if it is the heart drugs or the EF that has decreased that increase fatigue? .  Has anyone felt better once they started taking ace inhibitors and beta blockers  ie more engergy??   Also do people feel fatigued after getting the herceptin?    Thanks 

My cardio increased my Coreg dose on Wed. to 13 mg at night, and staying with the 6.25 in the am.  He wants me to hold on this dose for 2 weeks and then move into the 13 in the morning as well.  He felt that this might be my max.  At my checkup my bp was 117/78.  Mine started so high, it has given me more room to grow with the Coreg.  But, I have noticed that at least for the past week I am sleeping through the hot flashes for a change!  Or since I am sleeping harder, I am not having them.  Irregardless, I cannot imagine being on 25mg two times per day.  I have my next echo this Thursday.  I hope all these drugs are doing some good.

Just to vent a little- I am getting tired of taking all these meds.  I am taking more than my mother who is 95  OMG.  But hopefully they will keep the cancer away.  I am wondering if the fatigue I feel is due to the arimidex I recently started, the ace inhibitor or/ and beta blocker.  or the EF  which has not returned to what I started with.  Has anyone stopped the herceptin, then stopped the heart meds and there EF returned to normal??  I only have about 2 more herceptins to go or 6 depending on what my onc says.  I heard they are currently doing a study on herceptin to see if 2 years is better than one.  Also there was a study on just taking it for 3 months.  I attended a breast cancer conferenced this weekend and one of the oncologists said they just really don't know how long herceptin should be taken.  Maybe 10 years from now they will know.  The onc said that when they really don't know how long the treatment should be, they ask the patient to decide.   My intuition on this says if your heart is getting weakened and your quality of life is getting significantly impacted from the herceptin, then better to stop herceptin then get more heart damage.  Would love to hear other people's opinions on this. 

Good luck with MUGA and sending positive thoughts.  I am getting another MUGA after I get the herceptin tomorrow.  Then surgery scheduled for April 2 for reconstruction of breast.  Will keep you posted on what happens with the MUGA-  I wonder if there is any data on how many people have their EF return to normal after stopping herceptin??

I really need this thread. After the first herceptin infusion, I developed a jumpy heart. I felt chest pressure, and shortness of breath. My oncologist didn't seem too worried. One week before the second infusion the heart pressure disappear, but that week before the second infusion I had a fosamax reaction.

After the second infusion, my heart became so erratic that I could feel it pretty much all the time. I complained to my oncologist so she sent me to a cardiologist. The third week after the second herceptin infusion my heart seem to calm down so I feared the echo wouldn't show up any problems I compalined about or what I had been experiencing or feeling.

BUT...the cardio technician doing the echo said my heart from beginning to end was erratic and was surprised I didn't feel it. The next day she calls leaving me a message that my heart was slightly enlarged and the heart palpitations are normals. I never had palpitations before the two infusions, and I have a whole year to go. I haven't had the holter monitor evaluated or test results back yet.

To say the least, I'm a little frustrated. I' am going to change cardiologist to someone closer to where I live, and hospital specializing in cardio like Legacy.

If I'm going to take herceptin and with a family high risk with heart failure, I' want to be monitored by a cardio dr. Apparently a lot of bc women taking herceptin don't have heart problems. I need a little perspective to those who have wrestled with heart issues, and what to ask for. As of now, I'm not sure what ef numbers are or what to look out for.

Your stories help. Thanks.

I have had the same things happen to me this last month. After about my sixth TH tx...my heart started racing and when it did slow down I could still feel that it wasn't beating right. My onc first cut back on my premeds to see of that would help. Well it didn't..because that night I ended up in the ER because my heart rate was 220! So with only two more Taxol tx to go he decided to stop it and hold the Herceptin til I had an echo done. Well my echo showed that my heart function has decreased since January ( when I finished AC). So now we are stopping the Herceptin and doing another echo April 19th.

He still doesn't think I need to see a cardiologist...really? I think I should. I have nine more months of Herceptin! And....my family is plagued with heart problems...my father died at 45 of a heart attack. And he was in good health..no smoking..etc. I am only 37 so this is a little scary.



It's my understanding that we have to have the Herceptin right??? But what happens if we can't?

I have heard of tykerb...but don't know too much about it. I am hoping my next echo shows improvement. The 220 pulse was very scary...Especially since I was home w my nine yr old. Don't want that to happen again.

Has anybody here been on the Tykerb?

They are testing tykerb (lapatinib) in the ALTTO trial.

Here is the link 

and this    http://www.ncbi.nlm.nih.gov/pubmed/22257673 

http://www.cancer.gov/clinicaltrials/noteworthy-trials/altto 

My EF is now at 55.  Wonder if 3-1/2 months off Herceptin keeps me from starting again.  My onco says no more.