Aortic valve stenosis

[MSCripple]

Hello dear doctor, my dad who is a 62 year old chain smoker has been admitted to a local hospital after a bout of severe SOB and bloody sputum. On admission BNP was around 500 with progressive elevation of cardiac troponins. The cardiologist told us that echo showed dyskinesia on left ventricular walls and aortic valve stenosis with a severe audible murmur. He also told us that he suffered no MI and that the elevation in BNP and troponins was due to aortic valve problems. My dad suffered a syncope 6 hours after admission. We are considering transferring him to a hospital specialized in cardiac surgery. He is currently on a mechanical ventilator. Your opinion regarding this matter will be highly appreciated.

[MSCripple]

Thanks Dr. Rich, your advise is always very precise and effective.

[Jonathan D. Rich, MD]

Hello and welcome to the forum.

I am terribly sorry to hear about what your dad is going through.

Based on the information you provided to me, it sounds like he is suffering from the effects of severe aortic stenosis.  And if this is the case, from a therapeutic standpoint, there is no "medication" that will reverse his condition.  Medications can and should be use to stabilize him but he will ultimately require an intervention performed on his aortic valve (if this is the directon he would like to go).  Typically, the intervention is surgical aortic valve replacement.  However, in some instances, a less invasive approach referred to as TAVR can be used to replace the aortic valve while avoiding surgery (however only select hospitals perform this and he may/may not be an appropriate candidate).

If he is stable enough for transfer, I would highly encourage you to transfer him to a hospital highly skilled in complex valve surgeries and valve interventions if possible.

Wishing you only the best.

Dr. Rich