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enlargement of left atrium(PLZ HELP)
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enlargement of left atrium(PLZ HELP)

Iam suresh,age 50yrs,suffering from rheumatic heart disease.undergone open heart surgery for mitral valve replacement and tricuspid valvotomy in the year 1992 and i was all right with 5.5cm Left atrium up to December2007and the LV EF was60%.After 2 months i become very weekandlossed more than 10 kg wt2D echo showed LA size as 5.9 and LV EF as35%,prosthetic valve funcctiong well.After taking treatment I was all right with 60% LV Efand improved wt to 62kg.surprisingly since 15days iam getting week.On doing 2D Echo,the LA size is6.9cm  n LV EF is 60% and the NT-proBnp is 79.1.

Iam taking tab cordorone-100mg once daily, tab Eptus(epleronone)-25mg oncedaily,dytor-10mg,acetrome-3mg,  
Lanoxine-.25mg(1/2tab),metoprolol succinate-50mg(morning),25mg(bed time).
    
  Question is why the LA becoming such a large size,is there any chances of heart failure with this enlargement.Is there any surgery or any procedure to reduce the size of Lv size.Is it a reason for getting week n weight loss.
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