Illustration of a heart with a damaged aorta being injected with antibiotics.

Fluoroquinolones: Are Your Antibiotics Harming Your Heart?

Lena Kashyap in Health & Wellness November 2025 • 4 min read.

"New Research Links Common Antibiotics to Aortic Damage: What You Need to Know"

Fluoroquinolones (FQs) are a class of powerful antibiotics commonly prescribed to combat bacterial infections. They're known for their broad-spectrum activity, meaning they can tackle a wide range of bacteria, making them a go-to choice for many doctors. Conditions like pneumonia, urinary tract infections, and even some skin infections often find themselves on the receiving end of a fluoroquinolone prescription.

However, like many medications, fluoroquinolones come with their own set of potential side effects. While most people tolerate them well, some individuals may experience adverse reactions ranging from mild to severe. These can include nausea, diarrhea, headaches, and dizziness. More concerning, however, are the less common but more serious side effects such as tendon rupture, nerve damage, and heart-related issues.

Recent research has started to shed light on a potential link between fluoroquinolone use and damage to the aorta, the body's largest artery. This damage, known as aortopathy, can lead to aneurysms (bulges in the aorta) or dissections (tears in the aorta wall), both of which are life-threatening conditions. This article will explore these findings.

How Do Fluoroquinolones Affect the Aorta?

Illustration of a heart with a damaged aorta being injected with antibiotics.

A study published in The Journal of Thoracic and Cardiovascular Surgery has uncovered a possible mechanism by which fluoroquinolones might contribute to aortic problems. Researchers investigated human aortic myofibroblasts, which are cells responsible for maintaining the structure and integrity of the aorta. The study found that fluoroquinolone exposure can disrupt the normal function of these cells, leading to a breakdown of the extracellular matrix (ECM).

The extracellular matrix is essentially the scaffolding that holds the aorta together. It's composed of proteins like collagen, which provides strength and elasticity. The study revealed that fluoroquinolones can reduce the production of TIMPs (tissue inhibitors of metalloproteinases), which are crucial for preventing the excessive breakdown of the ECM. At the same time, these antibiotics impair the cells' ability to produce collagen, further weakening the aorta's structural integrity.

Decreased TIMP Expression: Fluoroquinolones significantly reduced the production of TIMP-1 and TIMP-2 proteins, which normally protect the aorta from excessive breakdown.
Increased MMP/TIMP Ratio: The balance between MMPs (matrix metalloproteinases) and TIMPs was disrupted, favoring increased degradation of the aorta's structural components.
Impaired Collagen Production: Fluoroquinolone exposure reduced the cells' ability to produce collagen-1, a critical protein for maintaining the aorta's strength.
ECM Degradation: The overall effect was an increase in the breakdown of the extracellular matrix, weakening the aorta's walls.

These findings suggest that fluoroquinolones may promote aortic damage by interfering with the delicate balance of ECM maintenance. This is especially concerning for individuals with pre-existing aortic conditions, such as those with bicuspid aortic valves or genetic connective tissue disorders. It’s important to note that this study was conducted in vitro, meaning in a laboratory setting using isolated cells. While the results are compelling, further research is needed to confirm these findings in humans.

The Takeaway: What Does This Mean for You?

The findings from this study highlight the importance of careful consideration when prescribing and using fluoroquinolone antibiotics. While these medications can be life-saving in certain situations, it's crucial to be aware of the potential risks, especially for those with pre-existing heart conditions. Always discuss the risks and benefits of any medication with your doctor, and be sure to report any unusual symptoms or concerns while taking fluoroquinolones. If you have a history of aortic problems, talk to your doctor about alternative antibiotics or strategies to minimize your risk.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.jtcvs.2018.08.079, Alternate LINK

Title: Induction Of Human Aortic Myofibroblast-Mediated Extracellular Matrix Dysregulation: A Potential Mechanism Of Fluoroquinolone-Associated Aortopathy

Subject: Cardiology and Cardiovascular Medicine

Journal: The Journal of Thoracic and Cardiovascular Surgery

Publisher: Elsevier BV

Authors: David G. Guzzardi, Guoqi Teng, Sean Kang, Patrick J. Geeraert, Simranjit S. Pattar, Daniyil A. Svystonyuk, Darrell D. Belke, Paul W.M. Fedak

Published: 2019-01-01

Everything You Need To Know

What are fluoroquinolones, and what are the potential risks associated with their use?

Fluoroquinolones are broad-spectrum antibiotics used to treat bacterial infections like pneumonia and UTIs. However, they can cause side effects ranging from nausea to more serious issues like tendon rupture and, potentially, damage to the aorta. Recent research suggests a link between fluoroquinolone use and aortopathy, which includes aneurysms and dissections.

What is aortopathy, and how is it related to the use of fluoroquinolone antibiotics?

Aortopathy, in the context of fluoroquinolone use, refers to damage to the aorta, the body's largest artery. This damage can manifest as aneurysms (bulges in the aorta) or dissections (tears in the aorta wall), both of which are life-threatening conditions. The risk appears to be elevated due to the impact fluoroquinolones have on the cells responsible for maintaining the integrity of the aorta's structure.

How do fluoroquinolones affect the cells of the aorta, according to recent research?

Research indicates that fluoroquinolones can disrupt the normal function of human aortic myofibroblasts, which are cells responsible for maintaining the structure of the aorta. They reduce the production of TIMPs (tissue inhibitors of metalloproteinases), crucial for preventing the breakdown of the extracellular matrix (ECM). Simultaneously, these antibiotics impair the cells' ability to produce collagen, weakening the aorta's structural integrity. This results in decreased TIMP expression, an increased MMP/TIMP ratio, impaired collagen production, and ultimately, ECM degradation.

What are TIMPs, and why is their reduction concerning in the context of fluoroquinolone use and aortic health?

TIMPs, or tissue inhibitors of metalloproteinases, are proteins that protect the aorta from excessive breakdown. Fluoroquinolones have been shown to reduce the production of TIMP-1 and TIMP-2, leading to an imbalance between MMPs (matrix metalloproteinases) and TIMPs, favoring the degradation of the aorta's structural components. This disruption weakens the aorta's walls and increases the risk of aortic damage.

What are the key takeaways from the study on fluoroquinolones and aortic damage, and what precautions should individuals take based on these findings?

The study highlighted the reduction of TIMP expression, increased MMP/TIMP ratio, impaired collagen production, and ECM degradation due to fluoroquinolone exposure. However, as it was an in vitro study using isolated cells, more research is needed to confirm these findings in humans. Individuals, especially those with pre-existing aortic conditions or heart issues, should discuss the risks and benefits of fluoroquinolones with their doctor and report any unusual symptoms while taking these medications. Alternative antibiotics or strategies to minimize risk should be considered, especially in those with a history of aortic problems.