Hello. Thank you for your question and welcome to HCM. I read your query. A insufficient heart or a insufficient pump is a situation where heart is not able to properly eject its blood content during systole. Thus, this produces an insufficient peripheral organ blood and nutritional supply, as well as causes high pressures in upper floors (i.e. lungs). In this condition, a great caution should be made and every thing that increases heart workload should be stopped. For example, salt should be refrained from his diet. He should not ingest alcohol. Also, all medical measurements should be made to lower this heart s workload and pressures, such as furosemide, spironolactone and an angiotensiogen converting enzyme inhibitor (ACE-I: captopril, enalapril, lisinopril), which I m assuming he is already on. Furthermore, my opinion is that, in this stage of congestive heart failure, you should discuss with your regular cardiologist about a possibility of ameliorating the quality of life and whether this subject is a good candidate for cardiac resynchronization therapy (CRT). All the above mentioned measures are undertaken to prolong lifespan and to slow down the progress of the disease. I hope I was helpful with my answer. Best regards.