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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Taking Coumadin. INR Keeps Dropping. Irregular Heartbeat. On Medication. Suggest?

I m taking my coumadin, in fact I m taking 7 mgs per day; but my INR keeps dropping; last checked it was 1.3. Only changes in my meds are, I dropped Digoxin and started Multaq 400 mg 1 tab twice daily; and started 1 fish oil capsule twice a day. I also take Atenolol 25mg 1 per day and Levolthyroxine .088mg 1 per day. At this very momemt I m have irregular heart beat. I know, I know; go to the ER but as I was told last time, I m already on the meds that I would be given so there is not much that can be done for me but to wait it out to see if my heart will goes back into rhythm on its own; lately it has; but it took a few days. What s has thrown me into afib the last few times was, strangely so, drinking very cold water. Any suggestions?
Mon, 4 Nov 2013
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General Surgeon 's  Response
Hi
As your history suggest you are having cardiac arrhythemias, but the to find out the cause a lot of things have to be done. Like your Thyroid function tests, cardiac echo, cardiac electro physiologic test and routine blood electrolytes with Ca++ and Mg++ levels. Even though with these tests a lot of Arrhythmic patients cause remains unknown which is a major bulk. There is no literature suggesting any relation with drinking cold water, but literature says exposure to chilled water causes arrhythmias. If you feel that cold water drinking precipitates it then prevent it.Hope this explanation helps.Please ask if you have any more questions.
Thanking you
Dr Samir
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Taking Coumadin. INR Keeps Dropping. Irregular Heartbeat. On Medication. Suggest?

Hi As your history suggest you are having cardiac arrhythemias, but the to find out the cause a lot of things have to be done. Like your Thyroid function tests, cardiac echo, cardiac electro physiologic test and routine blood electrolytes with Ca++ and Mg++ levels. Even though with these tests a lot of Arrhythmic patients cause remains unknown which is a major bulk. There is no literature suggesting any relation with drinking cold water, but literature says exposure to chilled water causes arrhythmias. If you feel that cold water drinking precipitates it then prevent it.Hope this explanation helps.Please ask if you have any more questions. Thanking you Dr Samir