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What Are The Chances Of Recovery In Case Of Massive Heart Attack?
PATIENT HAD MASSIVE HEART ATTACK, WAS IN ICU 3 ARTERIES AFFECTED SEVERLY, 2 STENTS AND 1 ANGIOPLASTY, WAS RELEASED FROM ICU, JUST NOW RETURNED TO ICU WITH SHORTNESS OF BREATH, PADDLES WERE USED AS AN INCIDENT OCCURRED, PREVIOUSLY IT WAS STATED THAT HE HAD 80% DAMAGE, I AM CLUELESS AS TO WHAT THIS MEANS, IF THAT MEANS 20% FUNCTION, EJECTION VOLUMNE OR TISSUE DAMAGE,
WHAT WOULD BE THE QUESTIONS TO ASK? WHAT ARE HIS CHANCES OF RECOVERY? HE WAS SPEAKING SOON AFTER THE PREVIOUS BREATHING TUBES WERE REMOVED, HE ALSO HAD CRYOGENIC TREATMENT, BRAIN SCANS SHOWED EVERYTHING OK SO FAR. HEART IS THE QUESTION HE IS ABOUT 63 YEARS OLD.
WHAT WOULD BE THE QUESTIONS TO ASK? WHAT ARE HIS CHANCES OF RECOVERY? HE WAS SPEAKING SOON AFTER THE PREVIOUS BREATHING TUBES WERE REMOVED, HE ALSO HAD CRYOGENIC TREATMENT, BRAIN SCANS SHOWED EVERYTHING OK SO FAR. HEART IS THE QUESTION HE IS ABOUT 63 YEARS OLD.
Wed, 30 Dec 2015
Greetings. Welcome to HCM and thank you for your question. I understand your concern.
Patients suffering a massive heart attack lose a lot of the heart function. If the heart function, measured by ejection fraction, is normal between 55-70%, in this case we have to deal with a heart which works only 20%. This means that in one cardiac cycle, this heart pumps only 20% of its content and retains 80% of its content. Two problems are generated from this: first, this heart is insufficient and does not supply organs with enough blood, i.e. with oxygen and nutrients; second, the blood retained in the left ventricle produces pressure of emptying the blood coming from the lungs. So, the lungs will suffer this pressure and they will get filled with fluid (pulmonary oedema). After all of this has been sad, it is crucial that, among others, the therapy regimen should contain an angiotensiogen converting enzyme inhibitor (ACE-I), two diuretics (furosemide and spironolacton), oxygen when needed. If the stent was placed in a culprit artery that caused the heart attack, within 6 hours from the onset of the pain, there is a chance that this heart will regain some of its function. This can be evaluated with an echocardiogram 3-6 months after the heart attack, which is the time that a heart muscle needs to "un-stun".
Also, an enlarged heart comprises a risk factor for serious, life-threatening, malignant ventricular arrhythmias. When the patient is stable, it is appropriate to discuss about the possibility of implantable cardioverter-defibrillator (ICD) implantation. You can discuss even for the possibility of a biventricular pacemaker or a cardiac resynchronization therapy (CRT). Although, more benefits are achieved when the latter is implanted in an enlarged heart which is not dilated from a heart attack, but from other causes, it is worth to discus the possibility of benefit from it.
I hope I was helpful with my answer. Take care.
Regards,
Dr. Meriton
Patients suffering a massive heart attack lose a lot of the heart function. If the heart function, measured by ejection fraction, is normal between 55-70%, in this case we have to deal with a heart which works only 20%. This means that in one cardiac cycle, this heart pumps only 20% of its content and retains 80% of its content. Two problems are generated from this: first, this heart is insufficient and does not supply organs with enough blood, i.e. with oxygen and nutrients; second, the blood retained in the left ventricle produces pressure of emptying the blood coming from the lungs. So, the lungs will suffer this pressure and they will get filled with fluid (pulmonary oedema). After all of this has been sad, it is crucial that, among others, the therapy regimen should contain an angiotensiogen converting enzyme inhibitor (ACE-I), two diuretics (furosemide and spironolacton), oxygen when needed. If the stent was placed in a culprit artery that caused the heart attack, within 6 hours from the onset of the pain, there is a chance that this heart will regain some of its function. This can be evaluated with an echocardiogram 3-6 months after the heart attack, which is the time that a heart muscle needs to "un-stun".
Also, an enlarged heart comprises a risk factor for serious, life-threatening, malignant ventricular arrhythmias. When the patient is stable, it is appropriate to discuss about the possibility of implantable cardioverter-defibrillator (ICD) implantation. You can discuss even for the possibility of a biventricular pacemaker or a cardiac resynchronization therapy (CRT). Although, more benefits are achieved when the latter is implanted in an enlarged heart which is not dilated from a heart attack, but from other causes, it is worth to discus the possibility of benefit from it.
I hope I was helpful with my answer. Take care.
Regards,
Dr. Meriton
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most likely they were referring to his heart ejection fraction which refers to the fraction of blood being pumped out of the heart with each beat. often the term is used in describing the general condition of the heart, like the patient a poor ejection fraction or decreased ejection fraction. low ejection fraction is usually below 40% and people become symptomatic around 25%. it is a good sign that he has preserved mental capacity.
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Note: For further follow-up it is advisable to consult an emergency medicine specialist. Click here.
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