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Can Vicodin cause LBBB?

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Posted on Sat, 28 Nov 2015
Question: I was just diagnosed with LBBB after a stress test. I am 68yo, have late-stage Lyme disease, have had a bilateral mastectomy, currently on Lisinopril, Bupropion, Escitalopram, Levothyroxine, Anastrozole, baby aspirin, SMG-TMP, and several supplements. I had conjestive heart failure from my Herceptin treatments which improved, but not to previous levels. I work out three times a week with machines and do water aerobics as well as considerable walking pushing wheelchairs at a hospital on another day. I believe I have arthritis in my knees, shoulders, and neck. At times I need pain relief. Will taking aspirin, Vicodin, etc. adversely affect the LBBB? And should my heart doctor be searching for the cause of this condition? Thank you.
doctor
Answered by Dr. Ilir Sharka (58 minutes later)
Brief Answer:
I would explain as follows:

Detailed Answer:

Hello!

Welcome and thank you for asking on HCM!

Regarding your concern, I would like to explain that your clinical conditions are a bit complex, as we have several confounding factors.

We have from one side Lyme disease, which is actually well known for its adverse implications overall the body; with articular, cardiac and neurological involvements prevailing the clinical symptomatology.

Cardiac conductance disturbances (atrio-ventricular blocks, bundle branch blocks [LBBB or RBBB], etc) are among the most frequent complications of Lyme disease (infection) encountered in around 10% of untreated or not properly treated patients. They may be mild and transient but sometimes severe (complete atrio-ventricular block) and persistent requiring permanent cardiac pacing.

From the other side, we have cytostatics (Herceptin) cardiomyopathy and hypothyroidism, which both may influence cardiac conductance physiology.

Also a degenerative process of cardiac conductance system as well as a hidden coronary heart disease may be manifested with LBBB.

Coming to this point, it is necessary to perform a comprehensive differential diagnosis addressing all the above mentioned topics.

I recommend discussing with your doctor about the possibility of a Lyme disease relapse (as arthritis symptomatology and LBBB may be an underlying clinical expression). In this regards, it is important to review whether Lyme treatment has been according to the current guidelines, and the study of the overall clinical course (symptomatology, laboratory, etc). A Lyme disease specialist should be consulted.

A cardiac performance status should be reviewed (cardiac ultrasound, and even a cardiac MRI) for investigating LVEF, and other physiological indexes, as well as detecting possible structural adverse implications (fibrosis, focal inflammation, etc).

Regarding Aspirin and Vicodin, I would like to assure you that they don’t exert any adverse effects on cardiac conductance functioning (and hence on LBBB). So, you can use them safely.

Concluding the right responsible factor of LBBB (by the above recommended tests) could lead to a better management and possible recovery of the actual complains.

Hope to have been helpful to you!

In case of further uncertainties, do not hesitate to ask me!

Kind regards,

Dr.Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (1 hour later)
I am what they call 'CDC diagnosed' as I met their parameters when I was finally diagnosed with Lyme disease about '98. I believe I contracted Lyme when I was in Connecticut in the late '70s. I went to a neurologist when I had periodic blindness at age 30. Of course, Lyme wasn't even on the radar at that time. I was misdiagnosed with MS in the late '90s and injected Copaxone in my abdomen for about 18 months. I had a severe allergic reaction and stopped the drug. I was atypical for MS, and did not think that that was what I had, at any rate. I had antibiotic treatment for Lyme for about three months (in my arm) which was unsuccessful. I have been hospitalized for several days with stroke-like problems, go blind, lose use of my limbs, etc. I was told for years that this was all in my head. It may be as I have read that the spirochete bacteria (BB) hides out in cell walls in the brain, thus resistant to antibiotic treatment. Apparently there is no cure after so many years. I just deal with it. Do you still recommend a Lyme specialist? I will ask my cardiologist if he will perform the testing you suggested for the LBBB. Again, thank you.
doctor
Answered by Dr. Ilir Sharka (22 minutes later)
Brief Answer:
You are welcome!

Detailed Answer:
Hi again,

As you are actually in the chronic phase of Lyme disease, no therapy could eradicate the infection.

The reason for consulting a Lyme specialist is to review Borrelia reactivation by those specific antigen markers, underlying antibodies and specific leukocytes receptor transformations, etc.

This would help to review potential infection implications in your actual clinical findings.

My opinion is that at this point the most important issue is to closely monitor and manage potential Lyme disease complications.

It may involve all body systems and if not promptly treated, may severely affect your vital functions and seriously risk your health.

You need to review your cardiovascular functioning condition by consulting your cardiologist.

Wishing you a good health,

Regards,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 8488 Questions

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Can Vicodin cause LBBB?

Brief Answer: I would explain as follows: Detailed Answer: Hello! Welcome and thank you for asking on HCM! Regarding your concern, I would like to explain that your clinical conditions are a bit complex, as we have several confounding factors. We have from one side Lyme disease, which is actually well known for its adverse implications overall the body; with articular, cardiac and neurological involvements prevailing the clinical symptomatology. Cardiac conductance disturbances (atrio-ventricular blocks, bundle branch blocks [LBBB or RBBB], etc) are among the most frequent complications of Lyme disease (infection) encountered in around 10% of untreated or not properly treated patients. They may be mild and transient but sometimes severe (complete atrio-ventricular block) and persistent requiring permanent cardiac pacing. From the other side, we have cytostatics (Herceptin) cardiomyopathy and hypothyroidism, which both may influence cardiac conductance physiology. Also a degenerative process of cardiac conductance system as well as a hidden coronary heart disease may be manifested with LBBB. Coming to this point, it is necessary to perform a comprehensive differential diagnosis addressing all the above mentioned topics. I recommend discussing with your doctor about the possibility of a Lyme disease relapse (as arthritis symptomatology and LBBB may be an underlying clinical expression). In this regards, it is important to review whether Lyme treatment has been according to the current guidelines, and the study of the overall clinical course (symptomatology, laboratory, etc). A Lyme disease specialist should be consulted. A cardiac performance status should be reviewed (cardiac ultrasound, and even a cardiac MRI) for investigating LVEF, and other physiological indexes, as well as detecting possible structural adverse implications (fibrosis, focal inflammation, etc). Regarding Aspirin and Vicodin, I would like to assure you that they don’t exert any adverse effects on cardiac conductance functioning (and hence on LBBB). So, you can use them safely. Concluding the right responsible factor of LBBB (by the above recommended tests) could lead to a better management and possible recovery of the actual complains. Hope to have been helpful to you! In case of further uncertainties, do not hesitate to ask me! Kind regards, Dr.Iliri