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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Need Suggestions For Treatment After Being Suffered From Mild Heart Attack

father is 87 suffered mild heart attack two weeks ago. heart is functioning at 15 per cent, kidneys are producing very small amounts of urine. so they are failing. he is on oxygen at around 8 per cent. not eating drinking very little. How long can we expect hime to have to hang on thru all of this. thankyou
Mon, 28 Sep 2015
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Cardiologist 's  Response
Greetings! Thank you for your question and welcome to HCM. I understand your concern.

I am assuming he had a major heart attack, or at least, a prior heart attack and a second, mild, heart attack happened now. A heart functioning at 15% is accompanied with a poor prognosis. This means that heart pumps only 15% of its content, and this is not sufficient to provide enough oxygen and nutrient supply to the end-organs. Kidney is suffering from this phenomenon, because, as a compensatory mechanism, the organism "sacrifices" other organ supply to keep the brain going. Also, the pressures in the pulmonary circulation will be very high, since the pulmonary veins cannot drain their blood supply to the left heart chambers, because of the high content of blood in the heart, which is already there (the remaining 85%). This can easily produce life-threatening situations, such as pulmonary oedema. At this point, all the measures to prolong his life are mandatory, such as careful adhering to the treatment, which should include, among others, two diuretics, oxygen and an angiotensinogen converting enzyme; totally withhold salt from the diet, and confine to only minimal ambulations within the house, to perform necessary duties.

I hope I was helpful with my answer.

Regards,
Dr. Meriton
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Need Suggestions For Treatment After Being Suffered From Mild Heart Attack

Greetings! Thank you for your question and welcome to HCM. I understand your concern. I am assuming he had a major heart attack, or at least, a prior heart attack and a second, mild, heart attack happened now. A heart functioning at 15% is accompanied with a poor prognosis. This means that heart pumps only 15% of its content, and this is not sufficient to provide enough oxygen and nutrient supply to the end-organs. Kidney is suffering from this phenomenon, because, as a compensatory mechanism, the organism sacrifices other organ supply to keep the brain going. Also, the pressures in the pulmonary circulation will be very high, since the pulmonary veins cannot drain their blood supply to the left heart chambers, because of the high content of blood in the heart, which is already there (the remaining 85%). This can easily produce life-threatening situations, such as pulmonary oedema. At this point, all the measures to prolong his life are mandatory, such as careful adhering to the treatment, which should include, among others, two diuretics, oxygen and an angiotensinogen converting enzyme; totally withhold salt from the diet, and confine to only minimal ambulations within the house, to perform necessary duties. I hope I was helpful with my answer. Regards, Dr. Meriton