Should You Continue Taking Medications for Heart Failure After Vaccination?

Should heart failure medications be continued?

After receiving the Moderna vaccine, on the fourth day, I experienced irregular heartbeats and shortness of breath.
The doctor prescribed Kankun 1.25 mg and Erispan 0.25 mg.
I also take Crestor 10 mg daily.
I have undergone a resting electrocardiogram, a 24-hour Holter monitor, an echocardiogram, and X-rays, and the doctor said everything is generally okay, except for a mitral valve prolapse issue, which is not significant.
However, my NT-proBNP level is as high as 791, and so far, the cause remains undetermined.
The doctor mentioned that Kankun can be taken or not, as there is a concern about dependency, but when I stopped taking it for a few days, I felt a tightness in my chest.
When I take it, I feel lighter and more comfortable.
My blood pressure usually hovers around 90/50.
Should I continue taking Kankun daily, or is there a need for further medication? Thank you for taking the time to respond.

Yin Zhu, 50~59 year old female. Ask Date: 2021/09/09

Dr. Wu Xueming reply Cardiology

If blood pressure is not elevated, it is recommended to discontinue the use of Concor and discuss this with the prescribing physician during an outpatient visit.

Reply Date: 2021/09/09

More Info

When considering whether to continue taking medications for heart failure after vaccination, it is essential to evaluate both the individual's current health status and the potential effects of the medications. In your case, you have experienced fluctuations in heart rate and shortness of breath after receiving the Moderna vaccine, which led your doctor to prescribe Concor (bisoprolol) and Erspan (an antihistamine). You also take Crestor (rosuvastatin) daily for cholesterol management.

From a medical standpoint, heart failure management often involves a combination of lifestyle changes and medications. Medications like beta-blockers (such as Concor) are commonly prescribed to help manage heart rate and reduce the workload on the heart. However, in your situation, where you have a history of low blood pressure (90/50 mmHg), the use of beta-blockers may need to be carefully monitored. Low blood pressure can lead to symptoms such as dizziness, fatigue, and in some cases, worsening heart function.

Your NT-proBNP level of 791 is elevated, indicating some degree of heart stress or failure. This biomarker is often used to assess the severity of heart failure, and while your doctor has indicated that your heart condition is stable aside from mild mitral valve prolapse, the elevated NT-proBNP suggests that your heart is under some strain. It is crucial to address this with your healthcare provider, as they can provide tailored advice based on your overall health and specific symptoms.

Regarding the use of Concor, your doctor has mentioned that it can be taken or omitted, but you have reported feeling better when taking it. This subjective improvement is significant and suggests that the medication may be beneficial for you, despite concerns about dependency. It is not uncommon for patients to feel a sense of relief from symptoms when taking their prescribed medications, especially in cases of heart failure or related conditions.

If you decide to continue taking Concor, it would be wise to do so under the guidance of your healthcare provider. Regular follow-ups are essential, especially given your low blood pressure and elevated NT-proBNP levels. Your doctor may want to monitor your heart function and adjust your medications as necessary.
In addition, if you experience any new or worsening symptoms, such as increased shortness of breath, chest pain, or significant changes in your heart rate, it is crucial to seek medical attention promptly. Your healthcare provider may also consider additional diagnostic tests to further evaluate your heart function and determine the best course of action.

In summary, while it may be beneficial for you to continue taking Concor, this decision should be made in consultation with your healthcare provider, who can assess your overall health, monitor your symptoms, and adjust your treatment plan as needed. It is essential to maintain open communication with your doctor about how you feel on the medication and any concerns you may have regarding your heart health and the effects of vaccination.

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