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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Complications With Decompensated Heart Failure

My husband is 68 and he has been diagnosed with acute decompensated heart failure! He has very little energy. The cardiologist has him on water pills and high blood pressure pills and a low salt diet.At first they mentioned a leaky valve but decided against surgery! How serious is this? YYYY@YYYY
Thu, 7 Aug 2014
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Internal Medicine Specialist,  's  Response
Hi! The cardiologist is indeed right in treating your husband's illness with appropriate medication. In heart failure the left chamber of the heart enlarges (dilates) due to weakness in the pumping action of the ventricular muscle. It is this dilatation of the ventricle that, among other reasons, leads to stretching of the valve making it 'leaky'. We still do not have enough definitive studies showing unequivocal benefit of valvular surgery (the commonest valve involved being the mitral valve) in patients with acute decompensated heart failure. The observational data is limited & conflicting. Ultimately it depends on the cardiologist's judgement of the patient's health status. Do write in for more info. All the best!
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  User's Response
Hi, thanks for posting your concern in the HCM. Acute decompensated heart failure is definitely a serious condition manifested as edema, dyspnoea, fatigue and raised JVP. In more severe condition fluid accumulation occurs in the lungs, causing pulmonary edema. Your doctor has correctly prescribed him diuretics, antihypertensives and low salt diet. The severity of the failure can be understood from the report of echocardiography. Information regarding left ventricular ejection fraction, wall motion abnormality, systolic and diastolic function of the heart is needed to comment on the severity of the condition. A leaky valve often needs surgery. But, that depends on the present status of the valve, presence of any other co-morbidity, the LVEF etc. Hence, my recommendation is that, please follow your doctor's advice. Regards. Dr. Kaushik
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Internal Medicine Specialist,  Dr. Divakara's  Response
HI

Welcome to HCM

Heart failure is a serious diagnosis but not a fatal condition . If properly treated he can lead a pretty decent life .

The severity of heart failure depends on how severe the patient's symptoms are .. Is he breathless even at rest ? Can He sleep comfortable lying flat on bed ? If he has difficulties then the severity is more .

Also they would have done a scan called 2D Echo and if Ejection Fraction in that is low it means the severity of heart failure is low .
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Suggest Complications With Decompensated Heart Failure

Hi! The cardiologist is indeed right in treating your husband s illness with appropriate medication. In heart failure the left chamber of the heart enlarges (dilates) due to weakness in the pumping action of the ventricular muscle. It is this dilatation of the ventricle that, among other reasons, leads to stretching of the valve making it leaky . We still do not have enough definitive studies showing unequivocal benefit of valvular surgery (the commonest valve involved being the mitral valve) in patients with acute decompensated heart failure. The observational data is limited & conflicting. Ultimately it depends on the cardiologist s judgement of the patient s health status. Do write in for more info. All the best!