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Is Medication Advisable To Treat Heart Failure?

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Posted on Thu, 13 Apr 2017
Question: Can medication halt stage 4 heart failure?
doctor
Answered by Dr. Panagiotis Zografakis (19 minutes later)
Brief Answer:
no

Detailed Answer:
Hello,

no, the drugs will only stabilize the patient by relieving some of the load on the heart (diuretics and other drugs). The process of functional deterioration cannot be reversed.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (2 hours later)
Ok well my dad was told 5 years ago he had heart damage. He had then had a heart attack and a bypass surgery for blocked Arteries.

He was on asprin ramapril and bisoprol.

He recent started getting breathless so a ecg was done and heart scan which showed heart failure and ejection fraction of 15.

He is not breathless at rest. Does this mean he progressed slowly on the meds ?

Also they say hes stage 4- but how can this be as he looks w
doctor
Answered by Dr. Panagiotis Zografakis (54 minutes later)
Brief Answer:
the cardiologist is the best person to classify him

Detailed Answer:
Stage 4 heart failure means that the patient will be breathless with any activity and may even be breathless at rest. An ejection fraction as low as 15% is very informative. It's very low obviously although only the symptoms are used to classify a patient.

With proper treatment (drugs) the symptoms can get much better but physical activity won't be tolerated.

Your cardiologist is the most appropriate person to classify him.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (41 minutes later)
He has
No symotoms at rest at all - only sometines breathless. What is survival time like usually at stage 4?
doctor
Answered by Dr. Panagiotis Zografakis (43 minutes later)
Brief Answer:
individual prognosis is not easy

Detailed Answer:
Individual prognoses are not accurate. I can only say that patients with symptomatic serious heart failure have a mortality rate of approximately 50% per year. Some patients may live for months, others for years. Your cardiologist can give you more accurate prognosis.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (1 hour later)
His symptoms are only breathlesness upon walking etc- not at rest . So cn he still be classed a stage 4?

Also he has a icd machine now - can that cause breathlesness ?
doctor
Answered by Dr. Panagiotis Zografakis (23 minutes later)
Brief Answer:
without symptoms a patient with advanced heart failure is usually a stage 3

Detailed Answer:
If he has absolutely no symptoms then he could be stage 3 but I doubt that. The cardiologist does not take into account breathlessness only. Refractory heart failure may have more symptoms (angina, edema, etc). I suppose his cardiologist evaluated all of them before classifying him. It doesn't make any big difference though. What's important is if treatment can 'fix' the symptoms. In stage 4 this is hard to achieve. But if he's OK then that's what matters the most.

One final note; the very low EF is also in favor of stage 4. It's very very low.

Regarding the ICD, it shouldn't cause any symptoms. It's there to protect him against serious arrhythmias.

Kind Regards!

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (7 hours later)
I see . Yes ge did have fluid retention in lungs, legs etc . They said he had 6 litres of excess water . And there is breathlesness upon walking etc

He did also mention he has signifucant cardiomyopathy which has caused heart failure.

Is it less likely meducation will do much because he had already been on ramapril asprin And bisoprol for 5 years n looks like has still progeessed slowly.?
doctor
Answered by Dr. Panagiotis Zografakis (3 hours later)
Brief Answer:
yes

Detailed Answer:
Drugs definitely help. In such patients diuretics have to be used as well. A combination of furosemide and spironolactone is very common. This is for the cardiologist to decide though.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (18 minutes later)
Ok at stage 4- is it poss
That drugs may not work ?
doctor
Answered by Dr. Panagiotis Zografakis (1 hour later)
Brief Answer:
yes

Detailed Answer:
Yes, this is what we call stage 4 actually. The heart failure is so advanced that even with drugs it's hard for the heart to make it. It's not the same for every patient though. Some patients perform better than others. Measuring body weight daily is a good indication of successful treatment. Patients with fluid retention will deteriorate and require more aggressive treatment.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (44 minutes later)
Ok. He had 6 litres excess fluid is that alot? With water pills is it likely that there will
Be no fluid now?

At age of 74 with stage 4 what is most average survival?
doctor
Answered by Dr. Panagiotis Zografakis (22 minutes later)
Brief Answer:
6L is significant retention. The diuretics may help.

Detailed Answer:
This is significant retention. Whenever his legs are swollen there are some extra litters under the skin. The diuretics will help to get rid of the extra fluid. In severely decompensated patients huge dosages might be required.

I've already answered the question about survival. It's not easy to do individual assessments. There is rough 50% risk of yearly mortality (that is only half of patients with make it through this year). Your cardiologist can do a much more detailed assessment but do not expect it to be very accurate. It will be a rough estimation.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (2 hours later)
What we are confussed with is on
doctor
Answered by Dr. Panagiotis Zografakis (2 hours later)
Brief Answer:
???

Detailed Answer:
I don't understand. Something must be missing from your question. Please explain...
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3814 Questions

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Is Medication Advisable To Treat Heart Failure?

Brief Answer: no Detailed Answer: Hello, no, the drugs will only stabilize the patient by relieving some of the load on the heart (diuretics and other drugs). The process of functional deterioration cannot be reversed. Kind Regards!