What could be done to manage stroke in a gout patient?

Question

Hi doctor,

My dad recently completed echocardiogram. The result is here with me in photo. I need a doctor to interpret the result and provide appropriate advise. Last year he had this report and one doctor has advised not to do surgery because of his age. He was taking medications since then and continue taking it now. Apart from this last year he had minor stroke and water in lungs. He was hospitalized for 10 years to take appropriate treatment. Also he has severe gout issue. Last week he underwent gout surgery on both legs. He has gout issue for the last 10 years. I have no one to look after him doctor. So I am taking action on his behalf. Thanks

Answer 1

Hi,

Welcome to icliniq.com.

Thanks for the query. He has to continue taking medicines. Surgery will be risky in his case. If symptoms are very uncontrolled on maximum tolerable medicines can be taken. If it does not help, then surgery is an option but he will need Coronary Angiography first and then if indicated 3 surgeries will be combined. 1. CABG (Bypass), 2. Mitral Valve repair or replacement, 3. Aortic valve replacement. As he has multiple comorbidities so these surgeries will be risky. Other options are medicines plus CRT device if indicated by ECG findings, plus or minus Mitra Clip, which is percutaneous mitral valve replacement but it is performed in few centers only. Regards