Can I Get the BNT Vaccine with Heart Rhythm Issues and GERD?

VPC and BNT vaccines

The patient has been on antihypertensive medication for 15 years and has been continuously monitored at Hospital A.
The original prescription included Metoprolol and Tenormin 25mg, which was changed to Concor 2.5mg a year and a half ago, maintaining stable control.
Two years ago, the patient began experiencing arrhythmias and underwent two 24-hour Holter monitor tests, both showing infrequent occurrences of APCs/VPCs with no other cardiac issues.
The doctor indicated that treatment was not necessary at that time and recommended observation.

In September of this year, the patient experienced discomfort in the stomach along with chest discomfort.
During these episodes, blood pressure and oxygen saturation were measured and found to be normal.
Subsequently, a doctor at Clinic B arranged for a 24-hour Holter monitor, which revealed over 23,000 VPCs in one day.
The doctor prescribed Rhythmol (one tablet in the morning and evening) along with gastrointestinal medication.
After one month of treatment, there was significant improvement in heart rhythm.

The patient then returned to Hospital A for a follow-up, where the doctor advised changing the Rhythmol dosage to one tablet in the morning, afternoon, evening, and before bed.
If the medication was ineffective, consideration would be given to catheter ablation.
An echocardiogram was scheduled for November 18 due to ongoing discomfort in the upper abdomen (experiencing burping whether eating or not, with a sensation of the heart "twitching" during burping).

At Clinic C, the diagnosis was severe gastroesophageal reflux disease (GERD), and the patient was prescribed a PPI before breakfast and dinner, along with medications for GERD.
The current medication regimen is as follows:
- Before breakfast: Esomeprazole
- After breakfast: Concor 2.5mg + Rhythmol + gastrointestinal medication
- After lunch: Rhythmol + gastrointestinal medication
- Before dinner: Pantoprazole
- After dinner: Rhythmol + gastrointestinal medication
- Before sleep: Rhythmol
The patient has been on this regimen for one week and reports relief from upper abdominal and rhythm issues.
The patient inquires whether it is safe to receive the second dose of the BNT vaccine under these circumstances or if it would be better to wait until after the echocardiogram on November 18.
Please provide guidance on this matter.
Thank you!

Huihui, 50~59 year old female. Ask Date: 2021/11/10

Dr. He Dongjin reply Cardiology

Hello, it's just a few days away.
Let's wait until the echocardiogram is completed on 11/18, and then we can discuss the report with the attending physician.
Everyone is more at ease.
Changhua Hospital cares about you.

Reply Date: 2021/11/10

More Info

Based on the information you provided, it seems that you have a history of hypertension and heart rhythm issues, specifically experiencing occasional atrial premature contractions (APCs) and ventricular premature contractions (VPCs). You are currently on medication to manage these conditions, and you have also been diagnosed with severe gastroesophageal reflux disease (GERD). You are considering receiving the BNT vaccine (BioNTech/Pfizer) for COVID-19.

Firstly, it is important to note that individuals with stable heart conditions, including those with mild arrhythmias like APCs and VPCs, are generally considered safe to receive the COVID-19 vaccine. The vaccines have been shown to be effective and safe for a wide range of individuals, including those with underlying health conditions. The key factor is that your heart rhythm issues are currently stable and being managed effectively with medication.
In your case, since your healthcare provider has indicated that your heart rhythm issues do not require immediate treatment and have advised you to continue monitoring your condition, it is likely that you can proceed with the vaccination. It is also reassuring that your recent treatment for GERD has provided some relief, indicating that your gastrointestinal symptoms are being managed.

Regarding the timing of your vaccination, it is advisable to wait until after your echocardiogram on November 18th to ensure that there are no new developments in your heart condition that might affect your ability to receive the vaccine. If your healthcare provider gives you the green light after reviewing the echocardiogram results, you should feel confident in proceeding with the vaccination.

As for your medications, it is generally recommended to continue taking your prescribed medications as directed, including those for your heart rhythm issues and GERD, before and after receiving the vaccine. There is no need to stop your medications unless specifically instructed by your healthcare provider.

In summary, based on your current health status and the management of your conditions, you should be able to receive the BNT vaccine. However, it is crucial to have a discussion with your healthcare provider after your echocardiogram to confirm that it is safe for you to proceed with the vaccination. They will be able to provide personalized advice based on your specific health situation.

In addition, it is essential to monitor for any unusual symptoms after receiving the vaccine, such as significant changes in heart rhythm, chest pain, or gastrointestinal discomfort. If you experience any concerning symptoms, do not hesitate to seek medical attention promptly.

In conclusion, vaccination is an important step in protecting yourself against COVID-19, especially considering the potential severity of the disease in individuals with underlying health conditions. By staying in close communication with your healthcare team and following their recommendations, you can make informed decisions about your health and vaccination status.

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