Saturday, June 29, 2013

Lipitor/Atorvastatin, Atrial Fibrillation and the possible need for a pacemaker.

I am not a doctor, however I am a CareGiver and wanted to share an unintended chain reaction that occurred when an atrial fibrillation patient on warfarin takes Lipitor/Atorvastatin.

It appears that Lipitor / Atorvastatin can cause the kidneys to "work harder", resulting in water retention. Depending on the dosage, age of the person, and other factors, not every patient will necessarily have water retention.

However, in this instance, it turned out that approximately every 3 to 5 days the patient needed a small dose of furosemide/lasik. I try not to give this everyday as it can be too hard on the kidneys and then one has to give a potassium pill as well.

However, when the furosemide/lasik is not given everyday, it then becomes a guessing game as to when the furosemide/lasik should be given. Watching for weight gain of more than a pound or two is one way to determine if water is being retained. 

But where all of this gets scary is if the patient's heartbeat beats too slowly. The combination of too slow of a heartbeat and water retention can create a life threatening situation as water can begin to form in the chest area. Some signs of water retention include weight gain, wheezing, and increasing blood pressure. The patient will probably not feel well, either.

In this instance, sudden water retention occurred. Taking the patient to the emergency room just 20 minutes later could have led to their demise. A pacemaker was recommended as the combination of too slow of a heartbeat and water retention can lead to a fatal result.

After the pacemaker had been installed I subsequently asked the heart doctor if we could stop the lipitor/atorvastatin for a while since the patient's blood pressure readings had been "normal". 

The result has been no water retention and therefore no need for furosemide/lasik.

After the pacemaker was put in, two days later the patient experienced another wheezing episode the evening of the afternoon they had been released from the hospital. The patient had gone almost one week with no furosemide/lasik. Some hospitals don't like to  prescribe furosemide/lasid for patients while they are in the hospital.

But maybe the pacemaker is what has stopped the water from pooling in the chest area? Pacemaker functions may vary, one of the functions is ensure the heart does not beat slower than 60 times a minute.

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