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Trying to quit smoking. Diagnosed with congestive heart failure. Life expectancy?

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A very dear friend of mine was diagnosed with heart disease, specifically cardio-myopathy and has only 20% heart function. She was hospitalized for congestive heart failure last November and is now working with her doctor to get the "right" mix of meds. She is 51. A smoker trying to quit and still drinks a couple to 3 glasses of wine/day. What is the prognosis for her and is there any way to determine how long she will live?
Posted Tue, 14 May 2013 in Smoking and Alcohol Addiction
Answered by Dr. Sukhvinder Singh 35 minutes later

Thanks for writing to XXXXXXX

It is so unfortunate that your friend has cardiomyopathy (I assume it is dilated cardiomyopathy) with Ejection fraction (pumping of heart) of 20%.

The prognosis in a given case of cardiomyopathy is determined by Ejection fraction, functional capacity (how much is ability to walk before getting breathless), cause of cardiomyopathy, bio-markers of heart failure and certain biochemical and ECHO parameters. It is said that once congestive heart failure is there, usually the course is downhill (studies of 1980s) but with a rider, that newer therapies like carvedilol, bi-ventricular pacing and XXXXXXX cardiac defibrillators have considerably changed the scenario even for these patients. 25%-33% of these patient can have a meaningful recovery with guidelines based treatment.

For an individual patient it is nearly impossible to guess the outcome because the natural history of cardiomyopathy is variable. Some patients have a rapid downhill course with death in less than 1 year, some of these may stabilize with drugs for variable period of time (which may be years) and then deteriorate and some may be able to improve their pumping and longevity also. In a trial, 25% of dilated cardiomyopthy patients recovered completely in 3 years (but mind it it was newly diagnosed , which I am afraid is not your case).

In summary, stop her alcohol and smoking immediately (alcohol can itself cause cardiomyopathy, and can worsen other cardiomyopathies). Consult a heart failure specialist and get her the best guideline based treatment and hope for the best.

Feel free to discuss further.

Wishing your friend a healthy life.

sukhvinder XXXXXXX

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