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Suggest Treatment For Low Ejection Fraction
Question: My husband had a MI with stent in '09, CABGx4 in '12 with complications and was in ICU for 2 mths/vent dependent, another recent MI on May 1...no stent nor a re-do CABG candidate. 2 weeks on meds after a year being off of them. He has severe CAD, smokes and is a major alcoholic. His LIMA/LAD is the only one open, EF was <20 and is currently wearing a life vest. I just want to know what I can expect... I feel totally deflated.
Thank you in advance.
Thank you in advance.
Brief Answer:
Prognosis is poor and probability of recovery becomes less in such situatn
Detailed Answer:
Hello,
I am sorry to mention, since ejection fraction is less, it's become difficult for other organs as well to sustain in absence of functioning heart. If patient needs support even to maintain the bp then probability of recovery further declines.
However, if bp and urine output is maintained then he may recover from the current episode but risk of readmission and deterioration will always be there. Only option available is of heart transplant if it's feasible there.
Overall, he is not having much time left with him. All the best.
Prognosis is poor and probability of recovery becomes less in such situatn
Detailed Answer:
Hello,
I am sorry to mention, since ejection fraction is less, it's become difficult for other organs as well to sustain in absence of functioning heart. If patient needs support even to maintain the bp then probability of recovery further declines.
However, if bp and urine output is maintained then he may recover from the current episode but risk of readmission and deterioration will always be there. Only option available is of heart transplant if it's feasible there.
Overall, he is not having much time left with him. All the best.
Above answer was peer-reviewed by :
Dr. Raju A.T
In reviewing his angiogram, I see that it also says the EF is <20 AND dilated. No gradient.
Does "dilated" and "no gradient" make it even more severe?
My brain hurts from trying to research all of this stuff---thank you for interpreting it for me.
Does "dilated" and "no gradient" make it even more severe?
My brain hurts from trying to research all of this stuff---thank you for interpreting it for me.
Brief Answer:
Yes dilated means severe
Detailed Answer:
Hello,
Yes dilated implies severity, but does not add to low ejection fraction. Low ejection fraction and dilatation are consequences of heart damage due to coronary artery disease or blockages. So if function decreases then it will be dilatated.
I guess, by meaning gradient, you are talking about aortic valve gradient and it's absence indicates absence of aortic valve disease, a good sign.
Few questions, how much exactly is his ejection fraction, how much is his blood pressure and level of consciousness. If these things are fine, one can improve a bit and perform basic daily activities. It's not absolutely incompatible with life. All the very best.
Yes dilated means severe
Detailed Answer:
Hello,
Yes dilated implies severity, but does not add to low ejection fraction. Low ejection fraction and dilatation are consequences of heart damage due to coronary artery disease or blockages. So if function decreases then it will be dilatated.
I guess, by meaning gradient, you are talking about aortic valve gradient and it's absence indicates absence of aortic valve disease, a good sign.
Few questions, how much exactly is his ejection fraction, how much is his blood pressure and level of consciousness. If these things are fine, one can improve a bit and perform basic daily activities. It's not absolutely incompatible with life. All the very best.
Above answer was peer-reviewed by :
Dr. Prasad
Thank you.
It just says his EF is less than 20. His BP was good yesterday (118/72), no
SOB, no swelling, coloring looks ok..not great and he's getting around just fine... although he can't walk for long...his legs hurt. He has another echo scheduled for XXXXXXX 12th and I'm anxious to see what his EF is then. With only medical therapy, how much can it actually increase? Should I be making him fulfill his bucket list?
It just says his EF is less than 20. His BP was good yesterday (118/72), no
SOB, no swelling, coloring looks ok..not great and he's getting around just fine... although he can't walk for long...his legs hurt. He has another echo scheduled for XXXXXXX 12th and I'm anxious to see what his EF is then. With only medical therapy, how much can it actually increase? Should I be making him fulfill his bucket list?
Brief Answer:
His ejection fraction may not improve but rate of decline will be slowed
Detailed Answer:
He is maintaining his blood pressure that means heart is contracting significantly and it's a good sign. Medical therapy will slow the rate of decline of ejection fraction but will not improve ef. Also, medical therapy will improve his quality of life and symptoms at that particular ef.
There will be a constant risk of life with such low ef so you should fulfill his bucket list.
He should maintain healthy lifestyle and avoid alcohol. Alcohol damages heart significantly and abstinence may improve ejection fraction if it has contributed to damage. You should also think of AICD implantation which will prevent sudden cardiac death in such patients.
His ejection fraction may not improve but rate of decline will be slowed
Detailed Answer:
He is maintaining his blood pressure that means heart is contracting significantly and it's a good sign. Medical therapy will slow the rate of decline of ejection fraction but will not improve ef. Also, medical therapy will improve his quality of life and symptoms at that particular ef.
There will be a constant risk of life with such low ef so you should fulfill his bucket list.
He should maintain healthy lifestyle and avoid alcohol. Alcohol damages heart significantly and abstinence may improve ejection fraction if it has contributed to damage. You should also think of AICD implantation which will prevent sudden cardiac death in such patients.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Prasad
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