Re: Recent medical issues with my mother and what they mean...

Posted By CCF CARDIO MD - DLB on February 12, 1999 at 18:06:39:

In Reply to: Recent medical issues with my mother and what they mean... posted by linda on February 12, 1999 at 13:29:31:






My mother is a 70 year old, semi retired, reasonably active woman, not overweight, with a family history of stroke and a personal history of hypertension. She has been on mini-press 1 mg. B.I.D. for at least 10 years and has recently added Lopresser 50 mg. 1/2tab B.I.D. SHe also takes "penn-Pro (?) and OTC vitamins.
Around 1996 my mother had an extended episode of dizziness. At that time an echocardiogram was done that she was advised was unremarkable. In December of 1998 she had another similar dizzy episode that again lasted an extended period of time - less than 24 hours I believe. At that point she was found to have 1+ mitral valve regurgiation and 2+ triscupid valve regurgitation. She was also found to have mild pulmonary hypertension with an estimated pulmonary artery pressure of 38mm. of mercury (I cannot find the other specific findings for which I could kick myself).
She has been given no diagnosis. TIA was suggested and to that end a head CT was performed. There was a new small area of low attenuation change in the region of the junction between the head and body of the right caudate nucleus and along the margin of the right frontal horn. Also a new very small rounded area of low attenuation at the inferior aspect of the left basal ganglion. No new cortical bsed wedge shaped area of low attenuation and the basal ganglia are otherwise well marginated. No pneumocephalus, patholigical intracranial calcification or acute intracaranial hemorrhage change. No evidence of a focal mass effect producing lesion. Impression: Since the head ct scan of 6/91, I believe there has been a development of small areas of low attenuation in the inferior left basal ganglion and adjacent to the left frontal horn approximating the junction of the head and body of the left caudate nucleus. There areas being thought most suspicious for areas of small vessel ischemic infarction. Negative exam for eevidence of acute large vessel ischemic infarction etc. Arterial carotid doppler sonography demonstrated no significant atheromatous plaque formation in the common and internal carotid arteries. The flow patterns and the waveforms are all within normal limits.
Several questions. What would cause such a drastic change in the echocardiograms in a span of a little over 2 years? Is there a connection between the cardiac findings and the brain changes? Can you comment on the brain changes or possibly refer me to another similar site for information/discussion of same (cheeky I know)? Is my mother a candidate for valve replacement and if so, given the above clinical picture, what timeframes (to the best of you ability given this forum)? In short, what should we be looking for, what should we expect and what does it all mean? My mother has gone to some pains to have a healthy middle age and now it seems that she is being confronted with something we cannot combat or control. Thank you for your time. If yoy need more info I sure I can get another copy of the missing echocardiogram results for more specifics.





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Dear Linda
There has been no drastic change in the echocardiograms. She has a minor degree of regurgitation of the mitral and tricuspid valves and mild pulmonary hypertension. None of this require any specific treatment, nor is it related to her symptoms. She does not need a valve replacement.
TIA sounds like a reasonable diagnosis. If she has not seen a neurologist as part of her work-up, she should. Medhelp, the sponsor of this site, has a neurology website as well.
I hope this has been useful. I wish you the best of luck. Feel free to write back.
Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.