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Suggest Treatment For Infective Endocarditis And Atrial Fibrillation
Question: Hi
My husband had infective endocarditis and was treated with antibiotics for a month. He was diagnosed as well with atrial fibrillation, congestive heart failure and non-rheumatic aortic regurgitation. He's currently on medications- furosemide, carvedilol, pantoprazole, perindopril and ferrous sulfate (he's also anemic). I want to ask if he can take Coq10, fish oil, hawthorne, multi vitamins and vitamin C. I read that they are all good for the heart and for his conditions. I'm just worried if there are interactions with his meds. Thank you so much!
My husband had infective endocarditis and was treated with antibiotics for a month. He was diagnosed as well with atrial fibrillation, congestive heart failure and non-rheumatic aortic regurgitation. He's currently on medications- furosemide, carvedilol, pantoprazole, perindopril and ferrous sulfate (he's also anemic). I want to ask if he can take Coq10, fish oil, hawthorne, multi vitamins and vitamin C. I read that they are all good for the heart and for his conditions. I'm just worried if there are interactions with his meds. Thank you so much!
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Thank you for asking on HCM!
Regarding your concern, I am glad to confirm you that there are not any serious interactions at all between your husband's actual therapy (each component) and the new potential additives ones (Coq10, fish oil, vitamin C, hawthorn).
So, it is safe to take all those drugs concomitantly.
BUT, this should be done only if his doctor advises such an action, and absolutely not otherwise, as there are clear cut indications for their use.
Meanwhile, I would like to explain you some potential interactions between his current medications.
(1) Furosemide may decrease, while Perindopril and Carvedilol may increase serum potassium. So, it is necessary to periodically check blood electrolytes (especially potassium), while on such therapy.
(2) Perindopril and Furosemide have a pharmacodynamic synergism. They may sometimes risk acute hypotension, and renal insufficiency. So, it is necessary to frequently monitor blood pressure values during their use. Renal function tests should be periodically sought too.
(3) Pantoprazole may decrease the level or effect of ferrous sulfate by increasing gastric pH. So it is necessary to check periodically blood Fe concentration.
Nevertheless, you need to be in close contact with the prescribing doctor and check treatment efficacy, and possible unpleasant interactions.
Hope to have been helpful to you!
Feel free to ask me whenever you need! Greetings! Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Thank you for asking on HCM!
Regarding your concern, I am glad to confirm you that there are not any serious interactions at all between your husband's actual therapy (each component) and the new potential additives ones (Coq10, fish oil, vitamin C, hawthorn).
So, it is safe to take all those drugs concomitantly.
BUT, this should be done only if his doctor advises such an action, and absolutely not otherwise, as there are clear cut indications for their use.
Meanwhile, I would like to explain you some potential interactions between his current medications.
(1) Furosemide may decrease, while Perindopril and Carvedilol may increase serum potassium. So, it is necessary to periodically check blood electrolytes (especially potassium), while on such therapy.
(2) Perindopril and Furosemide have a pharmacodynamic synergism. They may sometimes risk acute hypotension, and renal insufficiency. So, it is necessary to frequently monitor blood pressure values during their use. Renal function tests should be periodically sought too.
(3) Pantoprazole may decrease the level or effect of ferrous sulfate by increasing gastric pH. So it is necessary to check periodically blood Fe concentration.
Nevertheless, you need to be in close contact with the prescribing doctor and check treatment efficacy, and possible unpleasant interactions.
Hope to have been helpful to you!
Feel free to ask me whenever you need! Greetings! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much for the helpful and very detailed explanation Dr. Sharka.
So each and every medication has interaction with each other and it really scared me. Is it possible to change medications that has no side effects?
I'm afraid his doctor might not allow him to take those supplements that's why I asked you if it is safe.
And his doctor said his aortic valve might be replaced in a year or two. Is it possible that a damaged valve due to infection and vegetation heal on its own or heal with the help of supplements?
One more question, since he had endocarditis and I believe it has already been treated with antibiotics, what measures should he take to prevent infection of the valve again?
Thank you so much Dr. Sharka. Hope you will be patient to answer all my questions.
So each and every medication has interaction with each other and it really scared me. Is it possible to change medications that has no side effects?
I'm afraid his doctor might not allow him to take those supplements that's why I asked you if it is safe.
And his doctor said his aortic valve might be replaced in a year or two. Is it possible that a damaged valve due to infection and vegetation heal on its own or heal with the help of supplements?
One more question, since he had endocarditis and I believe it has already been treated with antibiotics, what measures should he take to prevent infection of the valve again?
Thank you so much Dr. Sharka. Hope you will be patient to answer all my questions.
Brief Answer:
You need to follow his doctor advice.
Detailed Answer:
Hello again!
Your husband's actual treatment seems almost safe with only some small exceptions that deserve more attention (as I explained you before). You don't need to change any medications, as long as they are working well and no any serious adverse effects has occurred.
I don't believe those supplements will offer any considerable additional help regarding his clinical improvement.
It is not possible for a structurally damaged valve to be healed on its own (regain its normal integral structure, even taking those supplements).
Your husband needs to be very attentive to avoid future bacteremia (that is exposing to any micro-organisms, that may enter blood stream and cause valve infection).
He needs to be careful even when washing his teeth (not to cause bleeding or inflammation), and take prophylactic antibiotics prior and after an invasive procedure (like tooth extraction, several endoscopic procedures, surgeries, etc). You need to discuss with his attending physician about underlying antibiotics schemes for each possible procedure.
Hope to have been helpful!
Best regards! Dr. Iliri
You need to follow his doctor advice.
Detailed Answer:
Hello again!
Your husband's actual treatment seems almost safe with only some small exceptions that deserve more attention (as I explained you before). You don't need to change any medications, as long as they are working well and no any serious adverse effects has occurred.
I don't believe those supplements will offer any considerable additional help regarding his clinical improvement.
It is not possible for a structurally damaged valve to be healed on its own (regain its normal integral structure, even taking those supplements).
Your husband needs to be very attentive to avoid future bacteremia (that is exposing to any micro-organisms, that may enter blood stream and cause valve infection).
He needs to be careful even when washing his teeth (not to cause bleeding or inflammation), and take prophylactic antibiotics prior and after an invasive procedure (like tooth extraction, several endoscopic procedures, surgeries, etc). You need to discuss with his attending physician about underlying antibiotics schemes for each possible procedure.
Hope to have been helpful!
Best regards! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you again for the well expounded reply Dr. Iliri! I'm really happy to have found this very helpful website!
I would like to ask several questions again. How does he get bacteria that might go to his bloodstream and eventually settle into the valve? Is it only through mouth infections, such as dental procedures and sore throat? Besides clinical procedures, like endoscopy and colonoscopy, where else could the bacteria originate?
Does he need to be careful of what he eats as well? How about yogurt and yakult? I used to give him those while he was on antibiotics because I was afraid it's killing all the good and bad bacteria in his body. Is it ok to still continue eating yogurt? will it cause possible complications?
Thank you so much Dr. Sharka!
I would like to ask several questions again. How does he get bacteria that might go to his bloodstream and eventually settle into the valve? Is it only through mouth infections, such as dental procedures and sore throat? Besides clinical procedures, like endoscopy and colonoscopy, where else could the bacteria originate?
Does he need to be careful of what he eats as well? How about yogurt and yakult? I used to give him those while he was on antibiotics because I was afraid it's killing all the good and bad bacteria in his body. Is it ok to still continue eating yogurt? will it cause possible complications?
Thank you so much Dr. Sharka!
Brief Answer:
Several ways of getting such an infection.
Detailed Answer:
Hello!
There are several way how a microbial pathogen can enter the blood stream and produce such devastating complications, like oro-pharyngeal route, by endo-venous route (inserted iv lines, long standing catheters, illicit drugs abusers, etc), and from several other systemic infections (pneumonia, urinary tract infections, GI infections, and many opportunistic agents in immune-compromised individuals, etc.
I do not have any specific recommendations regarding his diet, just to be a balanced one. I would recommend a healthy diet (like Mediterranean diet).
Yogurt is OK! It may be used also.
Best regards! Dr. Iliri
Several ways of getting such an infection.
Detailed Answer:
Hello!
There are several way how a microbial pathogen can enter the blood stream and produce such devastating complications, like oro-pharyngeal route, by endo-venous route (inserted iv lines, long standing catheters, illicit drugs abusers, etc), and from several other systemic infections (pneumonia, urinary tract infections, GI infections, and many opportunistic agents in immune-compromised individuals, etc.
I do not have any specific recommendations regarding his diet, just to be a balanced one. I would recommend a healthy diet (like Mediterranean diet).
Yogurt is OK! It may be used also.
Best regards! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much again Dr. Ilir for the very helpful replies.
Are CHF patients safe to fly? I'm planning to have a family holiday and we need to take the plane and travel for at least 1.5-2 hours at 38,000 ft. Is altitude going to be a problem?
I'm also afraid of fluid retention. What can we do so fluids won't go to his lungs, abdomen or extremities.
Thank you very much Dr. Ilir. Hope to hear from you again!
Are CHF patients safe to fly? I'm planning to have a family holiday and we need to take the plane and travel for at least 1.5-2 hours at 38,000 ft. Is altitude going to be a problem?
I'm also afraid of fluid retention. What can we do so fluids won't go to his lungs, abdomen or extremities.
Thank you very much Dr. Ilir. Hope to hear from you again!
Brief Answer:
Flying is OK, just check periodically his CHF therapy.
Detailed Answer:
Hi,
You shouldn't be afraid of flying, as it is more safe and comfortable than other means of travelling, no matter which altitude.
As the therapy is considered appropriate to his clinical status, no fear of fluid retention. Just keep being alert, and consult with his doctor periodically about ongoing treatment, and new clinical symptomatology
Wish you a nice holiday! Dr. Iliri
Flying is OK, just check periodically his CHF therapy.
Detailed Answer:
Hi,
You shouldn't be afraid of flying, as it is more safe and comfortable than other means of travelling, no matter which altitude.
As the therapy is considered appropriate to his clinical status, no fear of fluid retention. Just keep being alert, and consult with his doctor periodically about ongoing treatment, and new clinical symptomatology
Wish you a nice holiday! Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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