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Heart Disease (Expert Forum)
Palpitaions and Medication
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Palpitaions and Medication
by kitcurious, Jul 16, 2006 12:00AM
Hi there. Wrote last December doubting my previous MVP diagnosis and had a follow up echo (GP suggested) this year and got same Dx, almost exact same echo result in all categories of measurement.
My GP has recently informed me that I cannot take Excedrin Migraine (or decongestants) because I have palpitations. The doc is absolutely right, the EM does trigger palps like clockwork but I don't care as long as it ends that horrible head pain that I just started getting last spring. HA's started up right after 15 months of dizziness subsided. I talked to a pharmacist and he agreed that pretty much nothing else OTC works for migraines. Harmless palps do not scare me (they are benign and no one has said they were otherwise) so is there really any reason to avoid triggering them if this med helps me out of the excruciating pain that I very much DO mind?
I don't want to take all that amoxicllin before my twice yearly dental appointments or upcoming minor knee surgery either ( bad stomach upset). Does a "thickened redundant" valve significantly increase the risk of endocarditis in FACT, or is it more in theory? Are there statistics on this?
This doesn't seem like a real condition to me, not unless it has significant regurgitation (mine is mild) or stenosis. If there is a concrete reason to exercise any caution I will, but I suspect there isn't.
I suspect it's about liability (I don't blame doctors for that, it's the lawyers) and would be safe to go along just as I did when I didn't know I had it. I guess I make a pretty bad patient. Thank you for answering.
My GP has recently informed me that I cannot take Excedrin Migraine (or decongestants) because I have palpitations. The doc is absolutely right, the EM does trigger palps like clockwork but I don't care as long as it ends that horrible head pain that I just started getting last spring. HA's started up right after 15 months of dizziness subsided. I talked to a pharmacist and he agreed that pretty much nothing else OTC works for migraines. Harmless palps do not scare me (they are benign and no one has said they were otherwise) so is there really any reason to avoid triggering them if this med helps me out of the excruciating pain that I very much DO mind?
I don't want to take all that amoxicllin before my twice yearly dental appointments or upcoming minor knee surgery either ( bad stomach upset). Does a "thickened redundant" valve significantly increase the risk of endocarditis in FACT, or is it more in theory? Are there statistics on this?
This doesn't seem like a real condition to me, not unless it has significant regurgitation (mine is mild) or stenosis. If there is a concrete reason to exercise any caution I will, but I suspect there isn't.
I suspect it's about liability (I don't blame doctors for that, it's the lawyers) and would be safe to go along just as I did when I didn't know I had it. I guess I make a pretty bad patient. Thank you for answering.
Doctor's Answer
by CCF-M.D.-BJ, Jul 17, 2006 12:00AM
kit,
Thanks for the post.
There are specific guidelines for handling antibiotic prophylaxis for those with MVP. The short of it is that if your valve leaks, or shows structural abnormality such as thickening or myxomatous degeneration with MVP, then you should probably recieve prophylaxis.
The statisitcs for antibiotic prophylaxis are difficult, and there is some debate. The problem for me is that endocarditis is such a devastating disease with such a high mortality and morbidity, and the risk of taking an antibitoic is so small that its impossible to compare the risk benefit of the two.
There really shouldnt be any significant restriction on exercise from what you describe.
While defensive medicine does lead to over testing, I think most physicians still try to do the right thing overall for the patients without too much regard for getting sued.
You're not a bad patient for asking questions to make informed decisions. I would argure the contrary.
good luck
Thanks for the post.
There are specific guidelines for handling antibiotic prophylaxis for those with MVP. The short of it is that if your valve leaks, or shows structural abnormality such as thickening or myxomatous degeneration with MVP, then you should probably recieve prophylaxis.
The statisitcs for antibiotic prophylaxis are difficult, and there is some debate. The problem for me is that endocarditis is such a devastating disease with such a high mortality and morbidity, and the risk of taking an antibitoic is so small that its impossible to compare the risk benefit of the two.
There really shouldnt be any significant restriction on exercise from what you describe.
While defensive medicine does lead to over testing, I think most physicians still try to do the right thing overall for the patients without too much regard for getting sued.
You're not a bad patient for asking questions to make informed decisions. I would argure the contrary.
good luck
I have the EXACT same MVP situtation(mild regurge, redundant tissue) & migraine problems.
I too take Excedrin Migraine as I'm scare to take Imitrex. Sometimes it makes the palps worse, but half the time my head hurts so bad I can't tell. Can't wait to hear what the Doc has to say.
If palps really bother you, and I can certainly see why they would (especially if you get numerous ones) then I can easily understand avoiding anything that triggers them. My point is that I'm okay with what I experience in that regard so if there is no actual medical necessity to avoid the meds I plan to continue using them. I like dark choclate too :-)
Thanks again!
I also have MVP +2+3 and premedicate. This is very important. If you do not do well with amoxicillan, there are other antibiotic options I believe. Check with your Dr. or DDS.
Decongestants are also something I cannot take. It is the only substance that really causes me palpitations.
cristabelle
Good luck!
Hey Al, Thanks very much addressing my migraine question. My neurologist did give me an Rx for Inderal but, because it was a beta and once I started it I feared I couldn't just stop(in fact when he was writing the Rx he asked me "How good are you about taking your medicine every day?")I opted for the OTC. Possibly not the best choice of the two, but I can be stubborn. It has something to do with accepting certain things and I will get there.
I appreciate everyone's help a great deal.