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84 Years Old Is Having Lower Heart Function And Weakness. Treated For Chest Infection. Life Expectancy?

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Posted on Thu, 18 Apr 2013
Question: MY mother is 84 and is in the hospital and her heart is operating at 10%. She can't walk due to breaking her hip. She had a chest infection but that was cleared. She is slowly getting weaker. If she is not recovering, how long could she in theory stay like this? I know no doctor can answer definitively, but typically how long can someone go on with their heart this weak and not moving around?
doctor
Answered by Dr. Anil Grover (6 hours later)
Hi,
Thanks for writing in.
I am a qualified and certified cardiologist. I read your mail with diligence. Human heart is a muscle and rather a hard working muscle (contracts one hundred thousand times a day -72 x 60 x 24- and approx 2.3 billion times an average life time). This hard work takes its toll; more so when conditions like hypertension are present. Normal ejection fraction is above 50% and you have rightly put forth that it is functioning at 10% of it. Treatment in such conditions is palliative. Please, see cardiologist's options also which are limited by age. Heart Transplant, even if it is acceptable definite treatment and dual chamber pacing a palliative treatment can be offered to patients who do not have other medical conditions and are younger. An otherwise fit person is needed to tolerate such aggressive interventions. Therefore, perhaps the reluctance of your doctor. Secondly, despite all our "knowledge and wisdom", it is not always possible to predict what course a particular patient will take place. Let us pray and hope that she comes out of this with medical therapy only. If you have any specific question I will be most happy to answer it. Good Luck.
Best wishes

Dr Anil Grover
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Anil Grover (6 hours later)
Thank-you Dr. XXXXXXX I did not know that the normal heart function is just above 50%. I thought it was 100% if you know what I mean so 10% sounds very low then.
I suppose what I am trying to find out is, she seems to be slowly getting weaker so would this be a sign that the heart itself is weaker and could just give out. OR she is weaker as the body is tryign to recover. She is not eating much either. They were giving her diuretics to keep her fluid down but now she is dehydrated so they are giving her IV again.
Also do you think it would be ill advised to plan to move her home? We think she would prefer to pass away at home, if that is her destiny now.
Thanks for your help.
doctor
Answered by Dr. Anil Grover (17 minutes later)
Thanks for writing back. I empathize with you and want to dispute your assessment of her prognosis, however the facts speak for themselves. However, one question which your doctors can answer that if there has been recent deterioration as a result of some precipitating factor? And, if that is the case logical question is how much effective (or ineffective) in correcting that factor (or combination of factors). If that be the situation than the patient should be given all the chance. Depriving her would be akin to Euthanasia, which I do not support. On the other hand, it has been a slow deterioration than decision can be different. If there is any more question I will gladly answer that. Good Luck.
Best Wish Wishes.

Sincerely,

Dr Anil Grover
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Anil Grover (14 minutes later)
Hi Doctor - thanks again so much!
The factors that caused this are she had hip surgery due to a fall and they said durign teh surgery her heart was beating too fast. Then she was recoveing but during the recovery process, she got pnuemonia, and fluid collected on her lungs which caused her heart to beat too fast again - tafter she came out of that was when we were told her heart was at 10%. They cleared the pnuemonia medically but she seesm weaker as the weeks go by - she is not eating much and is not mobile - though she has tried physiotherapy but it leaves her very tired.
Is that enough of causes for her 10%? OR should we be askign the doctors for another precipitating factor? Can her heart get stronger after all that ? OR its unlikely?
thanks!
doctor
Answered by Dr. Anil Grover (3 hours later)
Thanks for raising a pertinent point.
The factors you mentioned are bad enough to push an already diseased (patient might have not been symptomatic) to contractility reflected by Ejection Fraction of 10%. Apart from nutrition the major issues are being addressed, therefore, it is a call for your treating doctors to take whether she will eventually recover. Even if there is a chance (I have personally seen patients recovering from such illnesses...not everyone but certainly a finite percent do recover). If that be the case, I will not take her home. Well, that is my personal opinion about someone whom I have not seen and treated; thus it is hypothetical. My suggestion is that you have one to one XXXXXXX talk with any member of treating doctor. He/She will be happy to take your specific question. Good luck. Take Care.

Regards

Dr Anil Grover
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Anil Grover

Cardiologist

Practicing since :1981

Answered : 922 Questions

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84 Years Old Is Having Lower Heart Function And Weakness. Treated For Chest Infection. Life Expectancy?

Hi,
Thanks for writing in.
I am a qualified and certified cardiologist. I read your mail with diligence. Human heart is a muscle and rather a hard working muscle (contracts one hundred thousand times a day -72 x 60 x 24- and approx 2.3 billion times an average life time). This hard work takes its toll; more so when conditions like hypertension are present. Normal ejection fraction is above 50% and you have rightly put forth that it is functioning at 10% of it. Treatment in such conditions is palliative. Please, see cardiologist's options also which are limited by age. Heart Transplant, even if it is acceptable definite treatment and dual chamber pacing a palliative treatment can be offered to patients who do not have other medical conditions and are younger. An otherwise fit person is needed to tolerate such aggressive interventions. Therefore, perhaps the reluctance of your doctor. Secondly, despite all our "knowledge and wisdom", it is not always possible to predict what course a particular patient will take place. Let us pray and hope that she comes out of this with medical therapy only. If you have any specific question I will be most happy to answer it. Good Luck.
Best wishes

Dr Anil Grover