<human>: 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.
<bot>: Hi dear. Given your detailed history of triple vessel disease and mitral leaflet prolapse and tricuspid regurgitation. I would suggest you to continue with the same medications. You can consult your doctor regarding dose adjustments of citron. Keep your INR under the reference range. And also ask your doctor about tab brilliant. I feel you do need citron because of your valve disease. Thank you .hope my answer helped you. Please do rate my answer