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Suggest treatment for shortness of breath and pneumonia inspite of having Congestive Heart Failure and Coronary Artery bypass Grafting?

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Practicing since : 1998
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My father, a 62 yrs old man who is a known case of Congestive Heart Failure and had undergone PCTA on 2006 and Coronary Artery bypass Grafting in the year of 2008. Recently [one month ago] he suffered from shortness of breath and pneumonia and used to be on oxygen at home as per the doctor's order.2 weeks before (8-2-2014) he was taken to a well equipped hospital with highly qualified doctors for the further review of his disease condition. As the response from the doctors who reviewed his medical reports were very much disappointing, I would rather seek your advice to help my father return to a state of well being with a healthy heart. Please help me settle this matter as soon as possible by advising me the further treatments and procedures my father can undergo for a good functioning heart.Recent medical reports and laboratory values of my father is here (Please find the attachment) for your evaluation and looking forward for your valuable reply. Thank you. Medical reports attached: Discharge Summary_14-02-2014 Coronary Angiogram Report_11-02-2014 Echocardiography Report_10-02-2014 Discharge Summary_07-03-2008 Opreation Note_25-02-2008 Thank you, XXXX
Posted Thu, 20 Mar 2014 in Hypertension and Heart Disease
Answered by Dr. Sukhvinder Singh 9 hours later
Brief Answer: please see details. Detailed Answer: Dear Sir 1. The documents state that your father has coronary artery disease and has suffered heart attacks in the past. His current pumping is very low and he is diabetic. He has severe leakage in one of his valves. He has moderately increased right sided pressures. 2. All the above things definitely make the situation grave and difficult. On the other hand the treatment as mentioned on discharge ticket has all the essential medications for heart failure as per standard international guidelines. Fortunately his hemoglobin and kidney functions are good. 3. His angiogram revealed unattended blockages to right circulation but intervention to totally occluded bypass graft is not advisable. Other methods to increase pumping include a biventricular pacemaker, however in absence of LBBB in ECG, he is not a candidate for same. Even cardiac transplant is contraindicated in patients with diabetes and end organ damage and for those with age more than 65 years. Hence things are not very good. 4. I would recommend to continue this treatment and if he still does not improve you may consult your cardiologist for few alterations in medications. That's perhaps the best scientific course for him. Although not yet proven fully, some people got some success with cardiac stem cell therapy in such cases. I am not a proponent of same but you can discuss the same with your cardiologist. I understand that to hear this is disappointing, however if there is any query I would readily answer to that. Sincerely Sukhvinder
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