Q: I am 38 years old and have had an aortic valve replacement two years ago. Kindly let me know whether smoking and consuming alcohol have any adverse effect on the valve and on my health in general? I am presently taking Acitrom 3 mg, Envas 2.5 and Ecosprin. Can a plan for a second child and will this lead to problems in my wife's pregnancy?

A:People who take Acitrom and Asprin are at a risk for bleeding. Both alcohol and smoking increase your chances for a stomach bleed. Also, alcohol can in a sense increase the action of Acitrom and produce bleeding tendency. Smoking predisposes people to heart attacks and you will not like to have another complication or surgery that needs opening of the chest a second time. At the same time, as you have a metal valve it is absolutely necessary that you take Acitrom and check your INR monthly to keep it in an appropriate range. You can safely plan a second child. Rheumatic heart disease is not hereditary. If you had a bicuspid aortic valve, even then the chances of you child having this problem is very minimal.