Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Shortness Of Breath And Severe Cough In An Elderly Person?
Question: Hi
My father is 67 years old and is having heart problem for the past 5 years. Recently he started having breathing problems(shortness of breath) and was coughing severely. If he did any physical activity he would start having breathing problems. At first we thought he had got asthma but later we did an ECHO test and we found that he had RHD(degenerative), moderate to severe MR and moderate to severe TR.
The doctors have given him medication,
TAB WARF,
TAB ATORICA,
TAB SARTEL, and one more which 1 cant remember.
He is having medicines for the past 15 days and rests the full days. He does not do much physical activity. Also his diet is reduced significantly.
With medication also he sometimes keeps having some breathing problems and coughing.
What can be the best course of treatment for him? Can medicines improve his conditions?
My father is 67 years old and is having heart problem for the past 5 years. Recently he started having breathing problems(shortness of breath) and was coughing severely. If he did any physical activity he would start having breathing problems. At first we thought he had got asthma but later we did an ECHO test and we found that he had RHD(degenerative), moderate to severe MR and moderate to severe TR.
The doctors have given him medication,
TAB WARF,
TAB ATORICA,
TAB SARTEL, and one more which 1 cant remember.
He is having medicines for the past 15 days and rests the full days. He does not do much physical activity. Also his diet is reduced significantly.
With medication also he sometimes keeps having some breathing problems and coughing.
What can be the best course of treatment for him? Can medicines improve his conditions?
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello,
Welcome on HCM!
Regarding your father's problem, I would explain that all his actual symptomatology seems to be related to heart failure. That is a blood circulation disorder due to decreased cardiac pumping function and also heart valves dysfunction.
based on your father's cardiac ultrasounds reports, it is revealed that he suffers from at least moderate mitral valve stenosis coupled with mitral regurgitation, which perfectly explain his breathing problems and coughing.
As the mitral valve narrowing impedes blood returning from the lungs to get inside the left ventricle, this will lead to subsequent pulmonary congestion, breathlessness and coughing.
Also, concomitant moderate mitral valve regurgitation will further aggravate this clinical scenario.
The resultant effect will be perceived also on the right side of the heart leading to increased systolic right ventricular pressure with subsequent dilation and important tricuspid regurgitation.
As a consequence, the chronic blood overload imposed within several heart chambers has led to heart chambers dilation and further regurgitation deterioration.
- At this point, the best therapeutic option would be to optimize the daily treatment with adding diuretics (like furosemide, torasemide), which could relieve pulmonary and systemic congestion, decrease heart overload and improve blood circulation.
- Because mitral valve stenosis is present, a beta-blocker would be helpful to maintain an acceptably low heart rate and improve blood flow through the mitral valve (by prolonging diastolic phase).
- As he has experienced a systemic embolism event (blood clot on his left eye) and has atrial fibrillation presence, anti-coagulation with warfarin is mandatory and should be followed by strict INR testing.
- At the end, because your father's valvular disease seems to be important (moderate mitral valve stenosis and regurgitation with adverse structura lheart implication [heart chamber dilation; decreased LV ejection fraction, and severe heart failure symptomatology], it would be wise to discuss with his attending cardiologist to review the possibility of a surgical solution [alternative] for the mitral valve disorder.
Hope to have been helpful!
In case of any further uncertainties, feel free to ask me again!
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello,
Welcome on HCM!
Regarding your father's problem, I would explain that all his actual symptomatology seems to be related to heart failure. That is a blood circulation disorder due to decreased cardiac pumping function and also heart valves dysfunction.
based on your father's cardiac ultrasounds reports, it is revealed that he suffers from at least moderate mitral valve stenosis coupled with mitral regurgitation, which perfectly explain his breathing problems and coughing.
As the mitral valve narrowing impedes blood returning from the lungs to get inside the left ventricle, this will lead to subsequent pulmonary congestion, breathlessness and coughing.
Also, concomitant moderate mitral valve regurgitation will further aggravate this clinical scenario.
The resultant effect will be perceived also on the right side of the heart leading to increased systolic right ventricular pressure with subsequent dilation and important tricuspid regurgitation.
As a consequence, the chronic blood overload imposed within several heart chambers has led to heart chambers dilation and further regurgitation deterioration.
- At this point, the best therapeutic option would be to optimize the daily treatment with adding diuretics (like furosemide, torasemide), which could relieve pulmonary and systemic congestion, decrease heart overload and improve blood circulation.
- Because mitral valve stenosis is present, a beta-blocker would be helpful to maintain an acceptably low heart rate and improve blood flow through the mitral valve (by prolonging diastolic phase).
- As he has experienced a systemic embolism event (blood clot on his left eye) and has atrial fibrillation presence, anti-coagulation with warfarin is mandatory and should be followed by strict INR testing.
- At the end, because your father's valvular disease seems to be important (moderate mitral valve stenosis and regurgitation with adverse structura lheart implication [heart chamber dilation; decreased LV ejection fraction, and severe heart failure symptomatology], it would be wise to discuss with his attending cardiologist to review the possibility of a surgical solution [alternative] for the mitral valve disorder.
Hope to have been helpful!
In case of any further uncertainties, feel free to ask me again!
Kind regards,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
