“What About Metoprolol After Heart Valve Surgery?” Asks Vielka

I just received several great questions from Vielka about the use of Metoprolol after heart valve surgery. In her email, Vielka was interested to learn “Why patients take Metoprolol after heart valve surgery?”, “Is it common for patients to take Metoprolol after the operation?” and “How long do patients stay on Metoprolol after surgery?”

Metoprolol After Heart Surgery

To get Vielka an expert response, I contacted Dr. Irving Kron, the Chair, Department of Surgery, at the University of Virginia Health System, and a key member of the UVA Advanced Cardiac Valve Center.

So you know, Dr. Kron is a cardiac guru having completed over 11,000 heart procedures of which more than 5,000 operations included valvular therapy. He’s also a super nice guy who responded to Vielka’s questions in less than 24 hours. 🙂

Dr. Irving Kron, MDDr. Irving Kron – Heart Surgeon

In his letter to Vielka, Dr. Kron first addressed what Metoprolol is:

You asked the question about Metoprolol after heart valve surgery. Metoprolol is a beta blocker which has the effect of reducing heart rate, blood pressure, and decreases the work load of the heart. This is a common drug that is used often after heart surgery and also in patients who have other cardiac conditions.

Then, Dr. Kron shared why patients take Metoprolol after heart valve surgery:

You asked why patients require Metoprolol and there are basically two reasons. One is to reduce high blood pressure after heart valve surgery to reduce the chances of bleeding. More commonly, it is used to reduce the incidences of an arrhythmia called atrial fibrillation. This is not a particularly dangerous arrhythmia but it can cause your heart to race. Atrial fibrillation is common after surgery and most people believe that Metoprolol will reduce the chances of this occurring. It is common for patients to be on this drug and I would say that the majority of our patients get this after valve surgery.

Lastly, Dr. Kron addressed the amount of time that patients stay on Metoprolol:

The final question is how long do the patients stay on it. Typically one stays on it for around a month but it can be indefinitely if you have high blood pressure. This is a very benign drug and is very commonly used.

I hope this helped you learn more about the use of Metoprolol after heart surgery surgery. Thanks to Vielka for sending me these questions and a special thanks to Dr. Kron for sharing his clinical experience and research with our patient community!

Keep on tickin!

Adam Pick
Written by Adam Pick

Adam Pick is a patient, author of The Patient's Guide To Heart Valve Surgery and the founder of HeartValveSurgery.com.

To learn how Adam has helped millions of people with heart valve disease, watch Adam's video, subscribe to his free newsletter, or visit his Facebook, or Twitter pages.

  • anon

    This is a timely post as I am trying to get off metoprolol about 4 years after valve replacement. In all that time my cardiologist of the time never suggested getting off earlier. A newer cardiologist (to me) told me two weeks ago I could basically go cold turkey. :/

    I have found in the past two weeks that my heart feels jittery. I had a scheduled ultrasound tomorrow and see the doc next week.

    Metoprolol certainly kept my heart in check. It has also been linked to weight gain (honest it was the metoprolol not the entire pizza), depression, sexual dysfunction (heh, well, certainly glad that never affected me, no sirree bob, not me, that was not one of my issues, not even for a second).

  • Kathy

    I’ve been on it for almost 5 years. I had a PVR done in 09. I hate this stuff. It’s caused to gain weight and have tremors.

  • Lynn Quast

    I took it for a few weeks and became extremely depressed so I stopped it and told my dr. He seemed fine with it since I wasn’t having any afib anymore. None since I stopped either. I had the same problem after my first heart surgery on this drug ! I’m glad to hear I wasn’t the only one . Thank you all for sharing!

  • Jill

    I was born with Aortic Stenosis; I have had 3 open-heart surgeries 2 of them being valve replacements. I have been taking Metoprolol extended release 50 MG everyday for over 10 years. I was first started on Metoprolol for migraines, but then my cardiologist told me just to remain on it, because it helps decrease the work load of my heart. A few years ago he wanted to increase it to 100 MG, not because I have hypertension or A-Fib, but only because he wanted to decrease the work load of my heart even more. I refused, because of how low my blood pressure runs. My only issue I have had with this medication is fatigue, but it’s not as bad as it was in the beginning. As a nurse and person who takes Metoprolol, I wouldn’t recommend completely stopping the medication all at once, but weaning yourself off, of course if only approved by your doctor. Best Wishes to everyone.

  • Pamela Hudson

    I have been on Metoprolol since my aortic valve replacement 11/2012. I have not had any problems taking it. I have managed to loose 20 pounds and keep it off. I feel great. I am glad to read this information it is good to know I had no idea the reason for taking it other than high blood pressure.

    Pam Hudson

  • Scott Carson

    Wife had totally endoscopic mv repair and was placed on any Beta Blocker. Rather, Aspirin was prescribed for approximately 1 month. Sounded like our Surgeon’s protocol.

  • Joan Taylor

    Had mitral valve repair April 7, 2014. BP would drop rapidly then go a bit too high. Heart rate never slowed down. Except for a nano second my resting HR has not not been below 100 since surgery. First took 1/2 of a 25MG Metoprolol, increased to a whole. No change in HR. BP ranges between 95 and 130 most of the time but changes quickly. Take NO other meds — except that I take two aspirin per day. Don’t want to think this is forever.

  • George S.

    I’ve had Aortic valve and root replacement surgery on 03/25/2014 and have been on metoprolol since that time. Started off with 25mg and then when I had my first a-fib it was increased to 50mg extended release. It has helped with my a-fib and I’m hoping that in a few weeks to be completely off of it. I have not experienced fatigue or any weight gain, nor any other symptoms since starting this medication.

  • KT

    I had an aortic valve replacement in 2008. I also had a 5 mm, ascending aortic aneurysm, which was repaired also. My cardiologist put me on metoprolol prior to my surgery, “for my aorta.” I don’t know about any weight gain or anything as I was only on it for maybe a week. My resting HR prior to Metoprolol was in the 50’s and if my BP got up to text book, 120/80, then I was doing something strenuous. When i slept my HR would drop into the 30’s to 40’s. Mind you I have been very athletic most of my life and was 48 when this all transpired. I was working on some sprinklers in my front yard and when I stood up I almost passed out. I immediately quit taking it “after calling my Dr,” and thankfully I have never been on it since. Coumadin is bad enough and that is all I take for my artificial valve. Good luck and God bless to those still on it.

  • Mark Howie

    I am 2 yrs post op double mechanical heart valve replacement. (aortic and mitral valves caused by endocarditis) I have no history of high blood pressure. I hate this pill. It effects so much. You know there are times when I need my heart to beat a little faster, if you know what I mean.

  • Joseph

    Hello to all. I had AVR surgery in July, 2011. I came through it great. Recovered completely and returned to playing Tennis, a sport I love. The only drug I was taking subsequent to heart surgery was Azor, for B/P. Last September, I developed Afib, a real Bummer. My Doctor put me on coumadin whic required routine blood work. But he did not restrict me from any athletics. I took the poison and continued in sports. Then in September of 2013, after two hours of tennis, a 33min jog on the treadmil, as I was on a holter monitor, a call come to my house telling me I should get to a hospital because they saw a series of 7 beats that were considered to be VTACH. I felt great no symptoms. But I went in to get checked. They kept me and insisted on putting in an ICD, a defibulator. I resisted the pressures of 5 doctors for 4 days, and best of all, no more VTACH. But they insisted, telling me that if I signed out of the hospital on AMA, I could die. They indiuced me, and put in the device. I was released after 6 days. Then I was put on Metoprolol 50mg, 2xday, Azor, 1xday, coumadin, 1/2xday. I returned to tennis. I have not been the same since. My endurance level is no longer the same, I’m depressed all the time, tired, fatigued and I am sexually dysfuntional. Now have ED. And I feel as though my light is going out. I spoke to my Doctor and he refused to make any changes to the medication although I have been OUT of AFIB for nearly a year. He refuses to cut the Metoporol because in his opinion, it is required to be protected 24 hours a day. So, I cut the Metoprolol to half the dose myself. Guess what? I feel better, no more ED, and I have more energy once again. The next thing I will do is find a NEW DOCTOR. Bless all of you, Joseph

  • Scott Carson

    In my response above I forgot to add the “NOT” before placed. Sorry about that.

    We were skeptical of Beta Blockers due to some of the side effects you all are discussing here so we were happy Dr. Guy (Temple) did NOT prescribe my wife Beta Blockers. She had some fluctuations in HR for about a month after but never even came close to A-Fib numbers. She was closely monitored during Cardiac Rehab (which Adam, I’m glad you pointed out the merits of) and never had A-Fib episodes either. Our local Cardiologist liked the fact BB’s were not prescribed and attributed that fact to the minimal invasive approach.

    Every surgeon has their own protocol so in our opinion it’s wise to ask all the questions and do your research. This blog couldn’t be MORE helpful.

    Thank You Adam.

  • David Stumpf

    I’m 51 . Dec 5, 2013 I had my aortic valve replaced along with a 7.5 mm ascending aortic aneurysm.Had a little jaw pain when working out and I’m alive because I went to my Doctor.!!
    Until last week I have been on Metoprolol since before my surgery. I would get easily fatigued, dizzy and short of breath when I placed any kind of work load on my body. Even just climbing a flight of stairs.
    Met with the cardiologist and he took me off the Metoprolol.last week. I dont get winded walking up stairs anymore but.I still get easily fatigued when trying to jog. My blood pressure and heart have always been low helping my cause to get rid of the Metoprolol.
    I just hope I will be able to jog again. Right now I walk more then jog and hope I improve or im going to lose my motivation.

  • Scott Carson

    David,

    Don’t lose your motivation whatever you do. Your ability to get up and out will carry you through the long days. I got my wife a FitBit for Christmas before her surgery and she doesn’t leave home without it – always trying to see how many steps she walked, how many calories she burned and how she compares to some the groups he’s a part of. Keep up the GREAT work and remember to not compare one day to another, but rather one week to the next or one month to the next.

    You’re awesome!

  • Renee L

    I had aortic valve replacement in 2000 with the Carpentier Edwards bovine valve. It will be 14 years in July 2014 and I’ve been fine ever since. I take both metoprolol and lisinopril, but I did have elevated blood pressure pre surgery. I was 49 when I had surgery.

    Don’t know if I’ll do it again when this one wears out, my plan is to wait until I can have min-invasive AND beating heart. My brain has never been the same since the 1st surgery!!

  • Kerstin Lampert

    I am taking Metoprolol, 50 mg twice per day (AM and PM) two months after aortic valve replacement with mechanical valve. I have high BP and high HEART RATE. I also need a second BP medication, losartan, 25 MG / day (AM) to hold down my BP.

    I expect I’ll be on this a long time. I took BP meds prior to my heart surgery, so it’s not strange for me.

    My heart beats are so loud, I can count my HEART RATE without a cuff, just by putting my ear down along my shoulder! It’s often in the 90’s when resting!

  • Diane G

    I was born with a bicuspid valve which had narrowed to a critical width so I had AVR on March 20, 2014. The surgery went great but the anesthesia brought out ALL of my MS symptoms (I have had Progressive MS since original diagnosis 20 years ago) which we knew it would. After about 8 weeks my symptoms settled back down to what they were before the surgery.

    I was put on Metoprolol after surgery. I developed a cough about 3 weeks after surgery which only got worse and worse. I was checked numerous times for pneumonia but that was not the case. My general dr. found I needed Oxygen because the cough was lowering my levels to about 74 instead of the 90’s where it should be. Because the only difference in my medications was the addition of Metoprolol I stopped the drug for about a week then resumed it at 1 pill a day and my cough came back to the point I couldn’t even say 5 words without a coughing fit. My asthma dr. (whom I saw about 6 weeks after surgery) informed me that this drug does not “play nice with asthma” and to keep a watch on it to see if any asthma symptoms appeared and could not be quieted.

    It suddenly dawned on me that it could be the Metoprolol that was causing my cough. So after stopping it a week later my cough was almost gone. I must say that Dr. Kron’s comment of “This is a very benign drug…” may not be true for those of us with Asthma.

    Now that the cough is gone I am able to complete my recovery .

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