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Mitral stenosis, - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: Hypertension and Heart Disease
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
Doctor :   hi
Doctor :  
how can i help you?
Doctor :  
please proceed with your health query
Doctor :  
are you there?
Doctor :  
please proceed with your health query
User :   Hi. This is regarding my father who is 56 years old and a known case of mitral valve stenosis due to rheumatic fever in his child hood. he had a CMV done on 1986 and sincve then he has been under medical supersvisions, his medicines include- cardace, pentids, acitrom,tonact
Doctor :   ok
User :   he is having hemoptysis since 3 days and has been told to stop all medications
Doctor :  
ok
User :   he is on augumentin,dicynene,amifru
Doctor :  
ok
Doctor :  
has the hemoptysis stopped now?
Doctor :  
is the blood fresh in color or altered?
User :   his echo diagnosis shows moderate mitral stenosis(MV0)-1.35cm2
User :   it sis fresh, it has stoped but a pinch of blood is seen early morning cough
Doctor :  
ok
User :   ther first 2 bouts were heavy with fresh blood
Doctor :  
symptom of hemoptysis does occur in patients with mitral valve stenosis
Doctor :  
but if controlled then it is fine
Doctor :  
after the hemoptysis occurred wa any repeat ECHO, dopler ultrasound done for him?
User :   yes.echo report shows
Doctor :  
yes please proceed with the report
User :   mvo-1.35 cm2 mild mr, PAH:no Cloots/effusion
Doctor :  
ok
User :   i have the report with me,
Doctor :  
was any chest x-ray done for him?
User :   yes it was done, the doctor said it seems quite normal.
Doctor :  
ok
Doctor :  
so the chest x-ray did not show any features of pulmoray hypertension?
Doctor :  
or pulmonary edema?
User :   NO
Doctor :  
or any evidence of hemorage in th elungs?
User :   but i have heared the doctors discusing that to stop acitrom to reduce pulmonary pressure. i did'.nt understand that. no evidence of hemorrage
Doctor :  
ok
Doctor :  
this could probably due to the possible pulmonary hypertension
Doctor :  
which they would have tried to bring down by stopping the drug
Doctor :  
was acitrom stopped?
User :   one of the doctors told us that it is time to replace the valve while other says you don't reqiure it now
Doctor :  
was the hemoptysis better once the acitrom was stopped?
User :   yes it is better now acitrom has been stoped immediately
Doctor :  
when was the valve surgery done?
Doctor :  
ok
User :   1986
Doctor :  
ok
Doctor :  
so it is possible that the vavlve replacement needs to be done
Doctor :  
Replacement valves can be made from different materials, some of which may last for decades and others which can wear out and require replacement.
Doctor :   since it is more than 20 years since the operation it is recommended that the valve replacement should be thought upon
Doctor :  
are you there?
User :   yes
Doctor :  
have you followed what i have said?
User :   they were saying that 1.32cm2 is good enough and you need not think of perating now.
User :   yes
Doctor :  
ok
Doctor :  
you can opt for a second opinion from our panel of specialist to take informed decision on what best will be to do for your father
Doctor :  
We shall present your case history to the concerned specialist and get back to you with an email.
User :   thank you very much. one more question? please
Doctor :   for this you will need to send us the scanned reports of all the procedures and investigations done for your father
Doctor :   yes please procced
Doctor :  
Please fill the feedback form while i answer your next query, and say done when done.
Doctor :   please proceed with your next health query
User :   My father has been on acitrom since almost 10 years. whwnever he stops it he feels shaky.he has stoped the same for 2 days now and i feeling shaky, the doctors say it's okay. now they have stared dicynene
Doctor :   ok
User :   i understand it is a coagulant. will there be any problem?
Doctor :   yes it is an antihemorragic drug that is given if hemorrage is suspected

Doctor :   so this will avoid any hemorage and control if any has happened
Doctor :  
which is resulting in the blood in the cough
Doctor :   Is there any thing else I can help you with?
User :   Is it because of narrowing of valve of hemorrage in brochila veins?
User :   or hemorrage in brochila veins?
Doctor :   i will help you in this
Doctor :  
this will require a proper understanding of the mitral stenosis itself to know what complications can arise leading to various symptoms
Doctor :  
shal i proceed with the explanation of the disease process?
User :   please do so doctor. i am very tense.
Doctor :   do not be tensed and worried, i will go ahead with the explanantion.
Doctor :  
it will help you to understand
Doctor :  
what is going on with your father
Doctor :  
Mitral stenosis is a heart valve disorder that involves the mitral valve. This valve separates the upper and lower chambers on the left side of the heart.
Doctor :   Stenosis refers to a condition in which the valve does not open fully, restricting blood flow.
Doctor :   In adults, mitral stenosis occurs most often in those who've had rheumatic fever (a condition that may develop after strep throat or scarlet fever).
User :   ok
Doctor :   The valve problems develop 5 - 10 years after the rheumatic fever.
Doctor :   In adults, symptoms usually develop between the ages of 20 and 50.
User :   ok
Doctor :   Symptoms may begin with an episode of atrial fibrillation or may be triggered by stress on the body such as infection in the heart or lungs, or other heart disorders.
Doctor :   symptoms include chest discomfort that increases with activity, radiates to arms, with feeling of tightening or crushing in chest
Doctor :  
cough with or without blood
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breathing difficulty
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fatigue
Doctor :  
pepeated respiratory infections
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palpitations
Doctor :  
complications include pulmonary edema
Doctor :  
and pulmonary hypertension
User :   ok
Doctor :  
in case either of these happen \then the symptom of blood in the cough happens and due to these the fine vessels in the lungs and bronchial tree rupture leading to bleeding
Doctor :  
that comes out in the cough
User :   right.
Doctor :  
other complications of mitral stenosis are atrial fibrillation, blood clots to brain (stroke), intestines, kidneys
Doctor :  
heart failure
Doctor :  
so this will require prompt medical attention
Doctor :  
as when the hemoptysis is large and uncontrollable, then it is difficult to save the patient
Doctor :  
since now your father's hemoptysis is controlled
Doctor :  
it is fine,
Doctor :  
and he should do regular follow up
Doctor :  
also, see on the option of valve replacment as more than 20 years are over
Doctor :  
and there are chances that there are wear and tear in the valve that is leading to these complications
Doctor :  
have you followed what i have said?
User :   yes doctor,
Doctor :  
Is there any thing else I can help you with?
User :   in which email id shall i send the scaned reports.
Doctor :  
yes i was bout to tell you that
Doctor :  
for the specialist opinion
Doctor :  
send the scanned reports
Doctor :  
since teh begiining till now
Doctor :  
to this id
Doctor :  
YYYY@YYYY
Doctor :  
mention as 'for specialist opinion' in it
User :   Okay.Thanks a lot doctor..
Doctor :  
we will present them to our panel specialist and get back to you within 24-48 hours
User :   okay.
Doctor :   with their opinion
Doctor :  
Please fill the feedback form again, and say done when done.
Doctor :   Thanks for consulting HealthcareMagic. Bye for now. Please chat with our doctors 24/7 for medical queries. Please refer your friends to our service.
User :   Okay. Bye.
Doctor :   please confirm your e-mail id
Doctor :  
and phone number
Doctor :  
in case we need to contact you
User :   YYYY@YYYY Phone number-0000
Doctor :  
and also to facilitate sending back the specialist opinion to you
Doctor :   thanks for the details
Doctor :  
Thanks for consulting HealthcareMagic. Bye for now. Please chat with our doctors 24/7 for medical queries. Please refer your friends to our service.
User :   thanks
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