ECHO: Fluid in Lungs & Mitrial Valve Prolapse

[carmela001]

I have cirrhosis from HBV. I was on Lam but got mutations after a year or so. By then Adefovir came out. I was in the trials and after the drug was approved, they kept me on it since. I was on the transplant list with Child-Pugh but taken off post -MELD.  MELD is now 12.  HBV undetectable. Ascites: med-controlled, 80mg lasix daily. I've had several varices bleeds but got the hospital on time. Yearly and bi-yearly endoscopies for sclerotherapy are proving beneficial. Banding did not work on me. That's when I had consecutive bleeds.

Recently I lost a lot of weight suddenly and have been coughing and hard to breath at night lying down. I was feeling stronger when I started consuming high calories in peanut butter sandwiches for daily. But I may be going way over allowed sodium intake just to keep from losing more weight..

I just had an echo showing I have fluid in lungs AND mitrial valve prolapse. I''ve been waking up with yellow thick flegm I have to gargle it out of my throat and I also noticed I cough if I walk or talk too much. Family doctor put me on antibiotics as of today and I have to see a pulmonary asap.

How can they remove the fluids in my lungs?

What tests will the pulmonary dr do? I need to know what to expect.

I've been doing good for many years. Did I just take a turn for the worse with this cardiopulmonary problem?
What if the fluids are due to increasing regurgitation in the heart?  

How soon would I be put on the liver transplant list and perhaps get to the top of the list, before my heart is permanently and severely damaged? Does my heart have to completely be failing me before I see a working liver?

What are the chances that the fluid in my lungs is caused from the valve prolapse as opposed to ascites backup?
How is prolapse in a cirrhotic treated?

I am very upset at this new heart problem and anxious as to how it affects me long term.

[Thomas D Schiano, MD]

i do not think the mitral valve prolapse is playing a role here.  If the HBV level is (-) then I doubt the fluid in the lungs is due to the liver unless a liver cancer has developed--I presume that you are having regular scans done. Another valvular problem or pulmonary hypertension could be contributing.  you do not lose anything by being placed on a liver transplant list.

i hope this is helpful

[carmela001]

Thank you for your very thoughtful reply doctor. Sorry for laying too many questions on you. I was very upset when I wrote the query. You are very MUCH appreciated.

Carmella