Q. Why could be the reason for breathing difficulty in breathing after mitral valve replacement?
Hello doctor,My mother is 59 years old and had undergone mitral valve replacement operation 15 days back. Now she is having breathing difficulty sometimes. SpO2 after exertion is 87 to 89 (without 02), the respiratory rate is around 28 to 30. I have attached the CT contrast thorax. There is no fever and wheezing. The echo shows only mild MR, and TR. No pulmonary hypertension and pleural effusion. She cannot take Duolin nebulization because she is a patient of atrial fibrillation, it increases her heart rate. But atrial fibrillation is under control by medicine. Please suggest the treatment.
Hello. I have gone through all the history you provided here. Your mother is currently suffering from two different problems. Mitral valve replacement followed by mild MR and TR as well as atrial fibrillation, are distinct cardiac problems. And according to you, she is taking prescribed medicines regularly.After going through the CT scans images (attachment removed to protect patient identity), it looks like she is suffering from some infective lesions in the lungs, most probably pulmonary tuberculosis (PTB). She is having breathing difficulty with low oxygen saturation, probably due to underlying lung infection. To confirm the diagnosis, further sputum tests are advised for sputum AFB (acid-fast bacilli) and culture tests. If no sputum sample is available, then induce sputum by nebulization with saline solution or perform a bronchoscopy. You are advised to consult pulmonologist doctor who will evaluate history and will advise recommended tests and medicines if required. Currently, symptomatic management includes oxygen supplementation with a high protein diet. Continue all cardiac medicines as advised. Depending upon the sputum AFB report, further treatment can be planned. I hope I have cleared all your doubts. In case you have any questions please do not hesitate to contact me again. Infection with PTB. Sputum AFB and Bactec AFB Culture. Depending upon sputum AFB report may require antitubercular treatment. Strictly use a mask while coughing and talking.