Posted in antibiotics, Health, medications, news

Popular Antibiotic Linked to Aortic Aneurysms and Dissections: FDA

The FDA has warned that a class of antibiotics commonly used to treat respiratory and urinary tract infections may increase one’s risk of artery tearing, ballooning or rupture.

This week the FDA reported that fluoroquinolones, such as those sold under the name Cipro (ciprofloxacin) and Levaquin (levofloxacin), could be associated with an increase risk of aortic aneurysm or dissection.

 

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In an aortic dissection the blood travels into the tear of a wall of the vessel.  In an aneurysm, the vessel bulges like someone stepping on a water hose.

 

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The FDA’s announcement reads as follows:

[12-20-2018] A U.S. Food and Drug Administration (FDA) review found that fluoroquinolone antibiotics can increase the occurrence of rare but serious events of ruptures or tears in the main artery of the body, called the aorta.  These tears, called aortic dissections, or ruptures of an aortic aneurysm can lead to dangerous bleeding or even death.  They can occur with fluoroquinolones for systemic use given by mouth or through an injection.
Fluoroquinolones should not be used in patients at increased risk unless there are no other treatment options available.  People at increased risk include those with a history of blockages or aneurysms (abnormal bulges) of the aorta or other blood vessels, high blood pressure, certain genetic disorders that involve blood vessel changes, and the elderly.  We are requiring that a new warning about this risk be added to the prescribing information and patient Medication Guide for all fluoroquinolones.

Medical providers are being advised to not prescribe fluoroquinolones in the elderly and those patients with:

  • High blood pressure
  • History of aneurysm
  • Peripheral atherosclerotic vascular diseases
  • Genetic disorders such as Marfan syndrome and Ehlers-Danlos syndrome

Aortic dissections and aneurysms that rupture could cause severe bleeding and loss of circulation to vitals parts of the body, leading to death.

Many with an aneurysm are unaware until it bursts.  A dissection or ruptured aortic aneurysm may be accompanied by sudden onset of severe pain in the chest, back or abdomen.  Moreover one can have weakness, shortness of breath, paralysis and loss of consciousness.

This is a developing story.

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in Entertainment, Health, news

Left us too early: Celebrities who have died of heart complications

Heart attacks happen all too often.  Unfortunately despite our recent advancements in tackling cardiovascular disease, heart disease is still the number one killer.  Plaques, made of cholesterol, fat, calcium, fibrin and other substances build up along the lining of blood vessels, narrowing their lumen and decreasing flow to the heart and other organs.  As these plaques build they can become unstable and rupture. The rupture can tear the wall of the blood vessel and cause an immediate clot. This thrombosis obstructs blood flow as well.

A heart attack occurs when the muscle of the heart does not receive the blood supply it needs. The heart muscle becomes stressed, injured and can die.  Dead heart muscle can’t contract, hence the heart cannot beat.  Though some have lived through their ordeal with heart disease, such as Former President Bill Clinton, Larry King, Dick Cheney, Barbara Walters, many are not as fortunate.  Carrie Fisher died December 27th after suffering a heart attack mid flight from London to Los Angeles.  George Michael the same week died of “heart failure”.  Alan Thicke, Growing Pains and beloved TV Dad, passed away from a thoracic aortic dissection.   The blood flow dissects the lumen of the aorta, the main artery coming off the heart, and this side pooling within the vessel prevents adequate blood flow from getting to vital tissues. In many cases, the heart stops.

These deaths and many others sadly highlight the premature and abrupt passing of many of our favorite artists.  These include:

Tom Petty (1950-2017) age 66 – accidental drug overdose, multi organ failure, cardiopulmonary arrest

Nelsan Ellis (1978-2017) age 39 – complications of heart failure

Bill Paxton (1955-2017) age 61 – stroke following heart surgery

Carrie Fisher (1956-2016) age 60

George Michael (1963-2016) age 53 – heart failure

Florence Henderson (1934-2016) age 82

James Garner (1928-2014) age 86

James Gandolfini (1961-2013) 51

Issac Hayes (1942-2008) age 65

Richard Pryor (1940-2005) age 65

John Ritter (1948-2003) age 54 – died of aortic dissection

Peter Sellers (1918-2002) age 83

Jerry Garcia (1942-1995) age 53

John Candy (1940-1994) age 44

Redd Foxx (1922-1991) age 68

Orson Welles (1915-1985) age 70

James Cagney (1919-1984) age 86

Bing Crosby (1903-1977) age 74

Louis Armstrong (1901-1971) age 71

Gracie Allen (1906-1964) age 58

and sadly more……

What causes a heart attack?

A heart attack occurs when part of the heart muscle fails to receive the blood and oxygen it needs. This can occur by arteries supplying the heart muscle to become blocked.  Coronary artery disease can be caused by plaque build up from fats, sugars, calcium, fibrin that settle on the blood vessel wall. These plaques can build up and occlude the lumen, obstructing blood flow.

Additionally a heart attack can occur when an unstable plaque rips off, tearing the blood vessel lining causing the body to form an immediate clot. This clot can also be deadly as it obstructs the lumen as well.

What causes an aortic dissection?

Tragically, many do not know they are at risk.  These risk factors include:

Arteriosclerosis

Age (greater than 65)

Family History

Tobacco use

Connective tissue disease

Marfan’s Syndrome

Heart valve issues

Infection – such as tertiary syphilis

What causes heart failure?

When the heart, whose main function is to pump blood, is prevented from doing so, it begins to “fail”.  For more on heart failure, read here:

https://doctordaliah.wordpress.com/2016/12/26/heart-failure-your-questions-answered/

Heart disease, however, can be prevented……..

Firstly, we must know our risk factors. These include:

Family history of heart disease

Personal history of heart disease

High Blood Pressure

High Cholesterol

Diabetes

Smoking

Obesity

Inactivity

Males over 40

Females who are post menopausal

High stress

and even short stature has been cited as a potential risk factor.

As you can see, many of us can be at risk for heart disease.  Therefore secondly, we should be evaluated with an EKG, echocardiogram and any other exams our medical provider and/or cardiologist deem necessary.

Thirdly, reduce your risk by the following:

Maintain a normal blood pressure

Maintain normal blood sugar

Maintain normal cholesterol and lipid levels

Reduce stress

Maintain a balanced diet, rich in potassium-rich foods such as fruits and vegetables

Quit smoking

Stay active

Maintain a healthy weight.

 

Life Line Screening offers screenings for stroke, heart disease, lung disease, liver and kidney disease, testosterone deficiency, and so much more that can be done in a private setting at the work place for groups of employees.  For more information call 1-888-815-LIFE.

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network and Board Certified Family Physician