Brief Answer: A few clarifications required sir/ma'am Detailed Answer: Hello sir/ma'am and welcome. Thank you for writing to us. I am sorry to hear about your father's poor cardiac health. But, there is something unclear with the information provided. 20 % is usually measured as the cardiac output, whereas heart rate is measure in beats per minute (normal range 60 -100). A heart rate of 20 BPM could be caused by various conditions and a life expectancy cannot be predicted based on that, whereas, a cardiac output of 20 % can help in calculating a life expectancy which would be anywhere between 2-5 months (5 months being extremely optimistic). But based on your history, you mention heart rate repeatedly, and that his heart rate was 25 %, so I am guessing you are not speaking about ejection fraction. Please clarify whether this is heart rate or not sir/ma'am, and I shall reply with a more elaborate explanation. Please also attach all documents from the doctor and all reports for my reference, because I cannot comment on the diet without the diagnosis sir/ma'am. Once I know which parameter this is and what the diagnosis is, I will be able to explain the precautions and diet accordingly. I await your kind response in order to help you further. I would also like to add, if an investigation called 2D echocardiography has not yet being conducted, please conduct the same and write back to me with the detailed report or you could attach the reports to our discussion and I shall go through this with diligence. I hope you find my response helpful. I am looking forward to hearing from you in order to help you further. Best wishes.

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Brief Answer: Thank you for that, all queries addressed Detailed Answer: Hello once again sir/ma'am. Thank you for that information. I can now comment on the life expectancy and other queries more accurately. A low left ventricular ejection fraction (LVEF) is a bad prognostic marker, and indicates poor prognosis for life. For a healthy heart, your ejection fraction needs to be at least 60 %. I am sorry to inform you that a low LVEF, especially that equal to or below 20 % has a life expectancy of 3-5 years sir/ma'am. Following are the most important diet recommendations suggested by various Heart Failure Management Institutes from across the globe: -Low-sodium diet -High-fiber diet -Low-cholesterol and fat in diet -Use food made with yeast, as it absorbs a lot of the salt -Avoid canned, tinned, packed or processed foods -Frozen food is acceptable -Use fresh fruits and vegetables -Avoided smoked food -Strictly not more than 2000 mg of sodium a day (please make sure this is strictly followed) -Avoid all meals from outside (as you cannot monitor the sodium levels) I hope you find my response both helpful and informative. Please feel free to write back to me for any further clarifications, I would be more than happy to help you. Best wishes.

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Brief Answer: Diet, lifestyle changes and medication Detailed Answer: Hello once again sir/ma'am. The most important factors that can help your father are: 1. Diet and lifestyle changes 2. Medication like beta blockers (eg. carvedilol), diuretics (eg. furosemide), ACE-inhibitors (eg. lisinopril), etc. Please speak to a cardiologist for the same. Medications will certainly help to increase the cardiac function and increase the LVEF as well. Wishing your father lots of luck and hope he has a beautiful recovery, and lives a long and healthy life. Please feel free to write back to me for any further clarifications, I would be more than happy to be of assistance. God bless.

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Brief Answer: All recommendations remain the same sir Detailed Answer: Hello once again sir/ma'am. I have gone through all the reports, and all my previous recommendations still stand. The only thing I would like to comment on is that the GP you visited thinks that your father is not taking his recommendations seriously. I would like to inform you that the stage of cardiac function that your father currently is in, is a very delicate state. And if he does not take all these recommendations seriously, the result can be very serious and god forbid even fatal sir. I say this with a lot of concern, please make sure he changes his lifestyle and takes all the recommendations more seriously sir. I hope and pray for your father's health and wishing him a long and healthy life. God bless.

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