Originally Posted by
rpenmanparker
Sounds like he may be taking Plavix or Eliquis as an anti-coagulant. I would guess he had angioplasty with the placement of a stent(s). The anti-coagulants are necessary to prevent clot formation especially in the regions around the stents. They can cause fatigue. But with all due respect, what can you hope to accomplish asking a question like this on a cycling forum? Your brother is surely under the close care of a cardiologist. Why isn't HE asking his doctor the question?
Survivors of a heart attack are also frequently prescribed a combination of drugs for control of blood pressure and heart function such as a beta-blocker and an ACE inhibitor. The beta-blocker can have a significant effect on exercise performance since it limits the heart rate besides controlling blood pressure.
Finally the damage done to the heart, resulting scar tissue, and loss of heart performance are likely themselves responsible for some or all of your brother's lack of energy and poor cycling capability. I know that the heart damage and drugs combined caused me about a 20% loss in average speed (from 20+ mph to 16 mph) after my heart attack 17 years ago. Nevertheless I feel normal in my everyday activities, and have no problem cycling on a regular basis within these limitations.
The medications prescribed for heart attack patients are critical to their long term survival. I credit them with keeping me alive all these years since my attack. The drug cocktail used by heart attack survivors is very important for keeping the heart from further degenerating due to a phenomenon called "remodeling" which eventually can result in congestive heart failure. I recommend you counsel your brother to work with his cardiologist to tailor his medications in a way that will still be effective without causing him such unpleasant side effects. This is nothing to play around with. Unilaterally changing or stopping one's medication is a dangerous course to embark on with any disease, none more so than with heart disease.
Your advice and information are spot on. I currently have seven stents in place and can vouch for the accuracy of your information.
The biggest concern with anti-coagulants like Effient, is the high risk of uncontrollable bleeding in case of a major injury. That is a real risk and cause for concern.
Another potential risk is internal bleeding, that may not be readily noticeable, resulting from an injury. I hit my head and it caused internal bleeding that was not readily apparent. Months later, when the headaches and vomiting began to show up, I was diagnosed with a subdural hematoma.
So if someone is on anti-coagulants be very careful of any injuries or blows to the body that may cause bleeding.
Ride safely.