What causes breathing difficulty after valve replacement?

Question

Hello doctor,

My mother is 59 years old and had undergone a mitral valve replacement operation 15 days ago. Now she is having breathing difficulty, sometimes. SpO2 (oxygen saturation) after exertion is 87 to 89, and the respiratory rate is around 28 to 30.

I have attached the CT contrast thorax. There is no fever or 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 with atrial fibrillation, and it will increase her heart rate. But atrial fibrillation is under control with medicine. Please suggest the treatment.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through all the history you provided.

Your mother is currently suffering from two different problems. Mitral valve replacement followed by mild MR (mitral regurgitation, a heart condition characterized by the incomplete closure of the mitral valve) and TR (tricuspid regurgitation, a type of heart valve disease that occurs when the valve's flap), as well as atrial fibrillation (a heart condition that causes an irregular and often abnormally fast heart rate), are distinct cardiac problems.

And according to you, she is taking prescribed medicines regularly. After going through the CT (computerized tomography) scan images (attachment removed to protect patient identity), it looks like she is suffering from some infectious lesions in the lungs, most probably pulmonary tuberculosis (PTB).

She is having breathing difficulty with low oxygen saturation, probably due to an 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 (a procedure to look directly at the airways in the lungs using a thin, lighted tube).

You are advised to consult a pulmonologist, who will evaluate your history and 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 (acid-fast bacillus) 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.

Thank you.