Patient 76 years Old. Female - a Non Diabetic, non asthmatic with HIGH BP Stage II. Hypothyroidism on regular drug therapy - AMLP , ATLP and with AF with controlled VR [ On Acitrom] was admitted on 22.04.2014 with the c/o breathlessness and palpitaions. No H/O chest pain / sweating / giddiness / nausea or vomiting. PR 144/min, irregular [AF with Fast VR] BP 150/9O. Patient was conscious, oriented, afebrile. Became Stable with Torsemide and Amiodarone 300 mg over 30 min given intially. CAHD:Stable Angina: AML & PMLP: TVD. - Poor LV Functions - Tachycardiaopathy [ FS: 30 % EF: 58 %] Mild PAH with Sec TR [Estimated RVPSP: 46 MM HG] Mild MR: AF with Fast VR controlled with Injection: Amiodarone 300 mg High BP Stage II - Does not Tolerate Amlodipine [Edema ] / Hypothyroidism - TSH 7.51. At present taking Tab Thyrofit 25 mcg 1 0 1 Tab Metosarten 25 + 40 1 0 1 Tab Cardarone X 200 mg 1 0 1 Tab Dytor 5 mg 1 0 0 Tab Trizid SR 60 mg 1 0 1 Tab Korandil 10 mg 1 0 1 Tab Clopilet 75 mg 0 1 0 Tab Aztor 5 mg 0 0 1 Tab Acitrom 2 mg 1 @ 5 pm daily Tab Raliz D 1 0 1 [If needed for Acidity] Tab Ativan 1 mg 0 0 1 [ If needed for Sleep] Echocardiogram reveals Anterior Mitral and Posterior Mitral Leaflet Prolapse. Triple Vessel Disease ?? Atrial Fibrillation with Fast Ventricular Response during Study. Mild Pulmonary Arterial Hypertension with Secondary Tricuspid Regurgitation. [Estimated RVPSP :46 mmHG] Becasue of taking Acitrom skin becomes Blakish and spreads in forearm, legs, thighs. PTT 38 CONTROL 14 INR 2.7 with 3 mg Acitrom daily. Tab Acitrom reduced to 2 mg. My question is whether Acitrom can be replaced with ECOSPRIN 150 or 75 mg.