Conversation: The conversation between human and AI assistant.
[|Human|] My mom is 90 years old, she has a heart valve problem (just a background). The issue currently is a quarter size purplish/blue spot on her thumb with swelling, redness and pain. It started from a tiny white bump on her skin. She did not prick her skin at all prior to the tiny white bump appearing. This is her third strange infection on her fingers in less than 6 months.
[|AI|]  Hello Thanks for posting here. As per your description it seems that she develops clots or embolic in the small arteries of the hand which leads to obstruction in blood supply and hence pain, swelling and redness. Sometimes vegetation (bacterial growths on valves) can lead to embolism or throwing away of clots from the heart to distant vessels, in this case arteries of her hand. Please do a 2 D echo to rule out these vegetation son the valves. Another important cause may be atherosclerosis of the hand arteries due to old age. Atherosclerosis causes the arteries to thin out leading to deficiency of blood supply and the above symptoms. In that case an upper limb Doppler is advice but since it involves only the thumb or finger it is unlikely to be picked up by a Doppler scan. I advise you to do a 2 D echo and start her on blood thinners like Esprit 75-150 mg. She should do well on that. If 2d echo does not show any vegetation, you can start her on tablet Rental 400 mg twice a day, which is a medication that increases the microcirculation. Wishing her good healthRegards