Hello. Thank you for asking on HCM. I understand your concerns. Heart failure with this figure of fraction ejection is a very delicate situation. A normal person s heart pumps 55-70% of the blood pool in ventricles in one systole. In your father s case, this pumping is about 20%. Now, this means that with this little blood pumped by heart, all organ systems in the body are risked not to be supplied properly. Also, this means that this heart contains 80% of blood from previous systole and there is not much room for other chambers to empty the blood into ventricles during the relaxing stage - diastole, ergo the pressures will be high in upper floors (predominantly in the lungs). Another risk is that this dilated (enlarged) heart is a potential for ventricular arrhythmias, which can be life-threatening. I rather would not talk about percentages of first year survivals, but I won t deny it either, that this case has a poor prognosis. To avoid decompensating this failed pump, the diet should be with no salt at all, physical activity limited only to the lightest and obligatory daytime activity. Further, you should be very careful and attached to the treatment, furosemide (Lasix), spironolactone, angiotensiogen converting enzyme inhibitor (ACE-I) and, if blood pressure is too low, inotropic agents (dobutamine, dopamine). I hope I was thorough in giving my opinion. Take care. Good day.