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What Is The Prognosis Of A Heart Failure?
Question: What prognosis
Like for severe heart failure
Like for severe heart failure
Brief Answer:
Poor prognosis.
Detailed Answer:
Hi,
Thanks or choosing HCM,
By severe heart failure i would consider that ejection fraction of patient is less then 20%.
Prognosis is poor if EF is less then 20% and IACD device should be implanted to prevent sudden cardiac death in patient.
However Treatment of choice is INITIALLY TO GO FOR Left ventricular assisted device followe by cardiac transplantation.
For further details kindly enclose Echo report of patient along with all symptoms.
Poor prognosis.
Detailed Answer:
Hi,
Thanks or choosing HCM,
By severe heart failure i would consider that ejection fraction of patient is less then 20%.
Prognosis is poor if EF is less then 20% and IACD device should be implanted to prevent sudden cardiac death in patient.
However Treatment of choice is INITIALLY TO GO FOR Left ventricular assisted device followe by cardiac transplantation.
For further details kindly enclose Echo report of patient along with all symptoms.
Above answer was peer-reviewed by :
Dr. Prasad
His ef is 15 on a heart scan .
It seems he's had heart damage for 6 yrs since he had a bypass for blocked arteries . He was on medication but not ever monitored .they said he has heart disease .
Had fluid in lungs and legs but no major symptoms except sometimes breathless only .
Icd machine is fitted as heart rhythm very dangerous thy said . What is survival time like ? He's 73 and can't have heart transplant
It seems he's had heart damage for 6 yrs since he had a bypass for blocked arteries . He was on medication but not ever monitored .they said he has heart disease .
Had fluid in lungs and legs but no major symptoms except sometimes breathless only .
Icd machine is fitted as heart rhythm very dangerous thy said . What is survival time like ? He's 73 and can't have heart transplant
Brief Answer:
less then 20% survival rate for 5 years.
Detailed Answer:
Hi dear,
Ejection fraction 15% is critically low, Prognosis of patient is usually very poor.He already had a ICD implanted and CABG done,Still his EF is 15%,That means that heart is detoriating.
Initially a stress thallium should be done to make sure that EF is only 15%.2d echo which is usually done at various centres is a manual test and results may vary.Try to understand the seriousness of situation,Even a diference of 5% EF can be important in his case.
As per you history he is having no major symptoms at present.A patient with EF 15% should ideally present with severe breatlessnes,angina,anasarca etc.
Please attach his ecg's,There can be a number of rhythm's in heart which are dangerous.When we are taking about a serious thing like survival time of patient,We should know all details.I hope you understand my problem,without even looking at E.C,g of patient how can i predict his life span.We can't take things casually.
However as per the brief history given by you chances of survival at a EF 15% are about 20-25% on proper medications(5 years).However cardiac arrest can happen any time.
Please mention in which scan was his EF diagnosed as 15%.
LVAD and Heart transplantation has been done on a number of patients more then 75 years of age successfully at XXXXXXX hospital New XXXXXXX So just because he is 73 doesn't mean he is not a candidate for LVAD.
for you information LVAD followed by Succesful implant has been done on a 93 year old patient last year.
As he is asymptomatic(mild symptoms) i would like to go through all his investigations and treatments,I don't feel his EF is 15%.
Kindly enclose all reports and treatment copies.
Thanks.
less then 20% survival rate for 5 years.
Detailed Answer:
Hi dear,
Ejection fraction 15% is critically low, Prognosis of patient is usually very poor.He already had a ICD implanted and CABG done,Still his EF is 15%,That means that heart is detoriating.
Initially a stress thallium should be done to make sure that EF is only 15%.2d echo which is usually done at various centres is a manual test and results may vary.Try to understand the seriousness of situation,Even a diference of 5% EF can be important in his case.
As per you history he is having no major symptoms at present.A patient with EF 15% should ideally present with severe breatlessnes,angina,anasarca etc.
Please attach his ecg's,There can be a number of rhythm's in heart which are dangerous.When we are taking about a serious thing like survival time of patient,We should know all details.I hope you understand my problem,without even looking at E.C,g of patient how can i predict his life span.We can't take things casually.
However as per the brief history given by you chances of survival at a EF 15% are about 20-25% on proper medications(5 years).However cardiac arrest can happen any time.
Please mention in which scan was his EF diagnosed as 15%.
LVAD and Heart transplantation has been done on a number of patients more then 75 years of age successfully at XXXXXXX hospital New XXXXXXX So just because he is 73 doesn't mean he is not a candidate for LVAD.
for you information LVAD followed by Succesful implant has been done on a 93 year old patient last year.
As he is asymptomatic(mild symptoms) i would like to go through all his investigations and treatments,I don't feel his EF is 15%.
Kindly enclose all reports and treatment copies.
Thanks.
Above answer was peer-reviewed by :
Dr. Prasad
Was a heart scan ultrasound
He's already had it for 6 yrs. but it's strange he has no symptoms except had fluid retention n sometimes breathless
What stage would this b ?
He's already had it for 6 yrs. but it's strange he has no symptoms except had fluid retention n sometimes breathless
What stage would this b ?
Brief Answer:
Stress thallium to be done.
Detailed Answer:
Hi dear,
As i suspected it wwas a heart ultra sound(2d echo).
Go for a test called stress thallium.
Most likely there is some problem with reports of echo.A patient with just 15% E.F can't be asymptomatic.
Go for a stress thallium test,After that we can predict the stage of congestive cardiac failure.
Symptomatically its grade 1 congestive cardiac failure.
According to E.F its grade 4 Chf.
Thanks!
Stress thallium to be done.
Detailed Answer:
Hi dear,
As i suspected it wwas a heart ultra sound(2d echo).
Go for a test called stress thallium.
Most likely there is some problem with reports of echo.A patient with just 15% E.F can't be asymptomatic.
Go for a stress thallium test,After that we can predict the stage of congestive cardiac failure.
Symptomatically its grade 1 congestive cardiac failure.
According to E.F its grade 4 Chf.
Thanks!
Above answer was peer-reviewed by :
Dr. Raju A.T
The symptoms he gets are very dry mouth sometimes when talking , recently diziness and only breathless sometines when walks . If stage 4 does that carry a low survival ?
Brief Answer:
follow up answer.
Detailed Answer:
Hi again,
Stage 4 heart failure means severe heart failure and Patient is a candidate for cardiac transplant and Left ventricular assisted device.Sudden cardiac death can occur otherwise.
Thanks
follow up answer.
Detailed Answer:
Hi again,
Stage 4 heart failure means severe heart failure and Patient is a candidate for cardiac transplant and Left ventricular assisted device.Sudden cardiac death can occur otherwise.
Thanks
Above answer was peer-reviewed by :
Dr. Nagamani Ng
But can this be stage 4 with only mild symptoms plus pt looks well ?
If hes had for 6 yrs, then hes not likely to
Survive long right if now ejection fraction is 15. ?
The icd machine will help with sudden cardiac arrest ?
If hes had for 6 yrs, then hes not likely to
Survive long right if now ejection fraction is 15. ?
The icd machine will help with sudden cardiac arrest ?
Brief Answer:
follow up answer.
Detailed Answer:
Hi again,
Please go through my previous answers.As i already told you i am not at all convinced that patient has EF of 15%.Though patient with EF 155 can be asymptomatic yet this is some thing very rarely seen.
According to NYHA congestive cardiacfailure is classified as-
Stage 1-Cardiac disease, but no symptoms and no limitation in ordinary physical activity, e.g. no shortness of breath when walking, climbing stairs etc.
Stage 2-Mild symptoms (mild shortness of breath and/or angina) and slight limitation during ordinary activity.
Stage 3-Marked limitation in activity due to symptoms, even during less-than-ordinary activity, e.g. walking short distances (20–100 m).
Comfortable only at rest.
Stage4-Severe limitations. Experiences symptoms even while at rest. Mostly bed bound patients.
If ejection fraction is not considered your father is in Stage 2.
Advice
Go for stress thallium.
Take in person secondary opinion from cardiologist(Physical examination including auscultation).
ICD will try to revert episode of fatal ventricular arrythmia but at a EF of 15% mortality is very high and chances of reversal are very low.
Thanks
follow up answer.
Detailed Answer:
Hi again,
Please go through my previous answers.As i already told you i am not at all convinced that patient has EF of 15%.Though patient with EF 155 can be asymptomatic yet this is some thing very rarely seen.
According to NYHA congestive cardiacfailure is classified as-
Stage 1-Cardiac disease, but no symptoms and no limitation in ordinary physical activity, e.g. no shortness of breath when walking, climbing stairs etc.
Stage 2-Mild symptoms (mild shortness of breath and/or angina) and slight limitation during ordinary activity.
Stage 3-Marked limitation in activity due to symptoms, even during less-than-ordinary activity, e.g. walking short distances (20–100 m).
Comfortable only at rest.
Stage4-Severe limitations. Experiences symptoms even while at rest. Mostly bed bound patients.
If ejection fraction is not considered your father is in Stage 2.
Advice
Go for stress thallium.
Take in person secondary opinion from cardiologist(Physical examination including auscultation).
ICD will try to revert episode of fatal ventricular arrythmia but at a EF of 15% mortality is very high and chances of reversal are very low.
Thanks
Above answer was peer-reviewed by :
Dr. Remy Koshy
But he did hace fluid retention and gets breathless spmetimes upon walking to the shower etc. Plus bp dropped bit and diziness little
Brief Answer:
Folow up advice.
Detailed Answer:
Hi again,
Fluid retention can be there even in grade 2 congestive cardiac failure.
As i have already described above grade 4 CHF means that patient is confined to bed(symptomatic even in resting phase) which he is not.
Drop in blood pressure is because of lowered ejection fraction.
Ejection fraction means amount of blood pumped in body in each contraction of heart.If ejection fraction is low,amount of blood pumped out of heart would be low leading to dropped blood pressure and dizziness.
Thanks
Folow up advice.
Detailed Answer:
Hi again,
Fluid retention can be there even in grade 2 congestive cardiac failure.
As i have already described above grade 4 CHF means that patient is confined to bed(symptomatic even in resting phase) which he is not.
Drop in blood pressure is because of lowered ejection fraction.
Ejection fraction means amount of blood pumped in body in each contraction of heart.If ejection fraction is low,amount of blood pumped out of heart would be low leading to dropped blood pressure and dizziness.
Thanks
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Ok thx. The dr did mention this is irreversible and severe. Does this mean they must havr all full results and they know it wont improve? He has had episodes where lying on bed and struggling to breathe... but only sometimes
Brief Answer:
Follow up answer.
Detailed Answer:
Hi dear,
I have seen patients picking up from 20% to 45% ejection fraction in one year post AICD.But proper medication should be given.
Though its not possible in every case but going through general condition of your father,I believe that he is a good candidate who can definitely pick up if treated properly at a quaternary centre under a experienced cardiologist.
Some drug suggestions to be discussed with your cardiologist are-
Trimetazidine -35 mg twice daily can play wonders.
Ace inhibitors like Ramipril 5 to 10 mg BD have shown great results
Spironolactone -prevent cardiac remodelling and improves e.f.25 to 50 mg twice daily initially.
All should be used in combination with a cardioselective betablocker and a thiazide diuretic.
I don't know why your cardioogist is so hopeless despite of the fact that patient is not having severe symptoms.
Please attach all reports and treatments,I want to go through them.
Regards.
Follow up answer.
Detailed Answer:
Hi dear,
I have seen patients picking up from 20% to 45% ejection fraction in one year post AICD.But proper medication should be given.
Though its not possible in every case but going through general condition of your father,I believe that he is a good candidate who can definitely pick up if treated properly at a quaternary centre under a experienced cardiologist.
Some drug suggestions to be discussed with your cardiologist are-
Trimetazidine -35 mg twice daily can play wonders.
Ace inhibitors like Ramipril 5 to 10 mg BD have shown great results
Spironolactone -prevent cardiac remodelling and improves e.f.25 to 50 mg twice daily initially.
All should be used in combination with a cardioselective betablocker and a thiazide diuretic.
I don't know why your cardioogist is so hopeless despite of the fact that patient is not having severe symptoms.
Please attach all reports and treatments,I want to go through them.
Regards.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Sum of these meds he has been on for 6 years but. Now they have increased to XXXXXXX dosage . But it looks like he has still progressed .
Brief Answer:
Folow up advice.
Detailed Answer:
Hi again dear,
If ejection fraction is just 15% then using only some of these medicines will not help.A proper treatment with combination of these medicines have to be done with regular follow up and monitoring.
For any further query i have to go through his details.I hope that you understand the intensity of situation,We are dealing with history of patient with EF only 15%.Random guesses and vague suggestion will not do any good to him.
Thanks.
Folow up advice.
Detailed Answer:
Hi again dear,
If ejection fraction is just 15% then using only some of these medicines will not help.A proper treatment with combination of these medicines have to be done with regular follow up and monitoring.
For any further query i have to go through his details.I hope that you understand the intensity of situation,We are dealing with history of patient with EF only 15%.Random guesses and vague suggestion will not do any good to him.
Thanks.
Above answer was peer-reviewed by :
Dr. Prasad
Ur right. With all this medicines - how much can prigression be slowed if was had ej of 15? Like few months, 1-2 years ?
Brief Answer:
Follow up advice.
Detailed Answer:
Hello again,
Frankly speaking going by ejection fraction 15% patient can have sudden cardiac arrest any time.
However going by symptoms he can suruvive easily for 2years.
Regards.
Follow up advice.
Detailed Answer:
Hello again,
Frankly speaking going by ejection fraction 15% patient can have sudden cardiac arrest any time.
However going by symptoms he can suruvive easily for 2years.
Regards.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Kampana
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