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What is the cure for infective Endocarditis and should I take vitamin K for high prothrombin time?

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Practicing since : 2004
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I went to the doctor yesterday because I was having major heart palpitations when I lay down and I could not lay down or sleep. I told him that they start a week ago when I got an infection in my right nostril that would not heal. The palpitation so were bad I could not lay down without my heart flipping out. I told the doctor that I think I have an infection because I have had body aches and continues bleeding of the nostril and foul smell, I also felt week. He performed 2 ekg's. 1 laying flat on my back and one laying on my right side which severely triggered these palpitations. It was all seen on the ekg which came back abnormal. Ekg #1 came back with Sinus Rhythm, Possible left atrial abnormality, left axis Deviation, and rSr (V1) - probable normal variant. Ekg #2 Sinus Tachycardia with aberrantly conducted supraventricular complexes with PVCs with PACs, Left axis deviation, rSr' (V1) - probable normal variant. This did not make sense since just 5 months ago I had an ekg, that was totally normal and echocardiogram what was normal except minimal mitral valve prolapse. So I then requested some blood work to check for infection. Lab results came back showing high white blood cell count of 12.2 with upper limit being 10.8 and high abs neutrophils of 10500 with upper limit of 7800. In addition, my prothrombin time with high at 11.9 with upper limit being 11.5. So I think it is obvious there is a bacterial infection. My concern is my heart. #1 should I be concerned Infective Endocarditis and Do I need to get on antibiotics asap and what type should I take. Also, should I just take more vitamin k for the prothrombin time?
Posted Fri, 7 Feb 2014 in Hypertension and Heart Disease
Answered by Dr. Benard Shehu 40 minutes later
Brief Answer: Advised starting antibiotics&cardiac echo... Detailed Answer: Hi, Your blood work did show possible infection, for which, I'd suggest to start a course with wide-range antibiotic such as of penicillin group. The echo cardiogram of July 2012 (2 years ago) did show a mild prolapse, which increases the chances for infective endocarditis. That's why it is a must to start the antibiotics. However, I insist to do another echo cardiogram to evaluate the anatomical properties of your heart and to determine if you have endocarditis or not. With regards to your prothrombin time, it is true that it is elevated. However, it is not as elevated as to start vit.K for the time being as long as there is no bleeding. Hope it answered to your queries! Dr.Benard Feel free to ask me other questions you might have!
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Follow-up: What is the cure for infective Endocarditis and should I take vitamin K for high prothrombin time? 7 minutes later
actually just had a normal echocadiogram and ekg 6 months ago. I do frequent testing for I am an athlete. I believe that these recent changes to the ekg are probably just rythum disturbance and or inflamation and will return back to normal after the infections gone, do you agree? do you recomend augmentin as a antibiotic or which one? will torpol xl work ok for the athrymias? I will redu the echo as well...
Answered by Dr. Benard Shehu 16 minutes later
Brief Answer: Recommended Augmentin&Torpol use.... Detailed Answer: Hi back , Thank you for following up. The changes in the EKG are due to arrhythmia, this is true. However, such arrhythmia has been triggered by infection and prolapse. Therefore, once the infection is reversed, the arrhythmia will be reversed too. With regards to Augmentin, it is of penicillin group, so, it is highly recommended. I would recommend it for at least 1 week until you do another cardiac echo. Torpol Xl will work ok for the arrhythmia, especially to stabilize heart rates. However, you should keep following up with your cardiologist, keep monitoring blood pressure and heart rate, record the results for further evaluation. Hope it answered to your query! Dr.Benard
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