Crestor Drug Side Effect Causing Chest Pain, Shortness of breath, Muscle Weakness, Sweating, Fatigue, And Low Sense Of Well Being -A Case report

In this blog we will review a pulmonary consultation that we received for evaluation of cause of  shortness of breath in a 52-year-old gentleman with a history of obesity, hypertension  and sleep apnea.

The patient started having chest pain and shortness of breath of gradual onset for about a month’s duration and during the workup of shortness of breath a CT scan of the chest ruled out a pulmonary embolism.  As he was experiencing on going  chest pain, a rib x-ray series obtained was shown to be negative for any rib fractures.  The patient had been evaluated for chest pain  in a local Emergency Room to rule out any myocardial infarction.  He was treated and released with no evidence of myocardial infarction. He had further progression of the shortness of breath and experienced sternal discomfort.  He also had noticed increase in leg discomfort and weakness of gradual onset for about eight months but more so lately.  He underwent a complete pulmonary function test for evaluation of asthma or any obstructive or restrictive lung disease , which had shown no acute abnormality.  He had no history of any asthma or on any inhaler.  The patient never smoked.  The chest pain had increased for about a week so that he needed to take round-the-clock Motrin for alleviation of the pain.

He underwent the stress test and it was negative.  He has a history of sleep apnea with no change in his sleep symptoms and he has been using his BiPAP regularly.  His regular medication included baby aspirin, Crestor 10 mg a day, and Bystolic for his blood pressure.

Given the negative cardiopulmonary workup, the Crestor was felt to be a side effect,  causing this side effects  which the patient was advised to hold for atleast 3 months and to see if any or some of the symptoms will go away or not.  In the interim he is to  undergo a cardiopulmonary exercise stress test for evaluation of dyspnea cardiac versus pulmonary or any deconditioning giving his obesity.

Cardiopulmonary exercise stress test was  also,  negative with normal exercise capacity and normal cardiac and pulmonary reserve with no evidence of any desaturation ( no drop of oxygen on exersion)  and normal anaerobic threshold ( suggest normal cirulation)  with normal gas exchange and no evidence of any cardiac or pulmonary limitation to exercise. Meaning there was  nothing related to the lungs or heart that would be the cause of underlying  shortness of breath and he was not deconditioned also. This again pointed to the drug side effect as a  cause of underlying shortness of  breath.

The patient was seen back in a month for a follow up .  In the interim, he had been evaluated by cardiology who recommended medical management and weight loss  with no need for coronary angiogram.

The patient reports 80% of the symptoms resloved after stoping Crestor and his  non-caridac  chest pain, shortness of breath, muscle weakness in the thigh, sweating, fatigue, and low sense of well being have resolved.  He reported to be more active since the Crestor was discontinued. Over all  patient reported  felt more happy as he was   more active in last month and  was able to bicycle in good weather.

Clinically, it is felt that the statin group of drug like Crestor  had a relation to cause shortness of breath and non-cardiac chest pain, muscle weakness and overall decrease in physical activity.  The symptoms show resolution in about a month since the Crestor was discontinued which would suggest a Crestor-related  drug side effect.

One need to know that drug side effects are diagnosis of exclusion meaning other causes of symptoms  needs to be ruled out. In this case as the work up was negative and symptoms improved dramatically suggested the Crestor drug side effect. In some cases we  have seen a slow resolution of symptoms and it may take 3-6 months and in some we have seen 12 months.

One of the common question that many patients or family  ask us that if some thing like this is there what we should do. If you or someone who is on statins or other drugs and experience unusual symptoms then it would be good to report to  your  heathcare provider. Some time it is one drug or combination of drugs causing adverse reaction.  It may be a drug side effect that need to be evaluated and discontinued if that is the case. If serious side effect is of drug is noted would be good to report to FDA. www.fda.gov.  It helps statastical analysis and drug safety.

This entry was posted in Crestor drug side effect, Pulmonary embolism, Sleep apnea, Statin drug side effect and chronic fatigue symptoms, Statin drug side effect or adverse reaction and tagged , , , , , , . Bookmark the permalink.

15 Responses to Crestor Drug Side Effect Causing Chest Pain, Shortness of breath, Muscle Weakness, Sweating, Fatigue, And Low Sense Of Well Being -A Case report

  1. Dr M Diddee says:

    I have found a similar situation with a patient with almost exact symptoms. We need to establish this side effect as most doctors are unaware and are advising patients to continue Crestor.
    Please let us get together and sort this out.

    • Kiran Viramgama M.D. says:

      Statin side effects are more then though of, and are underdocumented, under reported to FDA. In our practice we see statin side effects quite frequently. Specific sets of questions if asked to the patients about the muscle weakness, muscle pain, change in bodily pain, arthralgias symptoms, and its change after start of statin, depression are few common to start. We have seen clinically that statin increases the bodily pain, fatigue, arthralgias and joint stiffness.

      We have seen statin side effects as a cause of interstitial lung disease and ground glass opacities, shortness of breath, cough that did resolved in couple of our patients. we saw that in a followup visits after holding statins for about 3 months. A follow up ct scan of the chest which has shown the diffuse ground glass opacity resolves with no other sprecific treatment other then stoping the statin that patients is on. As statins are commonly prescribed drug would be good to be familiar with other side effects. Will write other blogs with statin side effects cases. Thanks for your feedback. Hope this will help improve patient care and awarness of drug side effects.

      See below for some helpful information link.

      https://www.statineffects.com/info/
      https://www.accessdata.fda.gov/scripts/medwatch/medwatch-online.htm

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  14. Kiran Viramgama M.D. says:

    Drug side effect are complex medical problems and needs expert assessment and follow up. Many drugs takes long ( months) to go off the body and not just few days. See the details of the case that has been discuss and its progression as it took so slowly in a healthy man to recover not just few days off medication (Crestor). We have expected this similar side effect to happen and wanted to have a case report so that further side effect is though as a part of medical work up and assessment of chest pain or chest tightness symptoms.

    One needs to be off or needs to be on Statin drug depends on risk benefits and patient-healthcare needs to make that decision. Statin drug side effects are far more common and underreported and underdiagnosed. If drug side effect continues can affect the health, functional status and quality of life. Mortality with statins has been reported so are not fully safe and are high risk drug for cardiovascular prevention. Statins are not completely safe drugs although good cardiovascular benefits is there and not every one tolerate it. About 25% have drug side effect and it varies. If there is suspected drug side effect ( Crestor in this case) one can be off for a period of time as recovery in may cases is very slow. Lot of times after a prolong time off may give an idea it is drug side effect or other medical cause. Possible other drug interaction is possible and other medical conditions needs to be ruled out. Willingness of a healthcare professional to allow patient off any drug ( Crestor in this case) is also part of management and comfort of patient-healthcare professional to make that decision. Lot of literature states holding for 6 weeks and in our observation it is about 3-6 months in young patient and 6-9 months in elderly. But this our observation. Again risk/benefit of statin is a key. If one thinks if all other medical causes are ruled out then drug side effect would be likely. CO Q 10 may help to recovery. Best wishes

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