Hi I am Mr Alfred Randles 2005/6 I had a massive heart attack where my mitral value burst and I ended up to have a triple bypass and the value repaired and a hole. In 2007 I had breathing problems and found out that my mitral value burst again and I had a mechanical value fitted. I have been suffering with my breathing again for over 18 months now and finely after an argument with my Doctor at our hospital he gave me a TOE and found i have mitral value regurgitation in para-value leak and other leak from another part of my mitral value prosthesis. He dose think that this lesion explains shortness of breath. he thinks there could be an element of ischaemia causing dyspnoea and i m taking Isosorbide Mononitrate at 30mg daily. I have been taking them fore 7 weeks and I don't feel any better. Sorry its so long