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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

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What causes heart failure?

Answered by
Dr.
Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 7016 Questions

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Posted on Wed, 29 Apr 2015 in Hypertension and Heart Disease
Question: Hi I have severe LV dysfunction, moderate to severe RV dysfunction, moderate MR and TR, severe LA and mild RA dilation and raised pulmonary pressures. I have been given a prognosis - could you comment?
doctor
Answered by Dr. Ilir Sharka 1 hour later
Brief Answer:
There are some important clues that tell us about HF patient prognosis.

Detailed Answer:

Hello!

Thank you for asking on HCM!

Regarding your concern, I would explain that when judging about a heart failure patient prognosis (as in your case), it is necessary to take into account some important clincal clues as follows:

(1) One of the most important feature for prognosis to judge on, is the primary cardiac disorder, that leaded to heart failure. May be an ischemic haert disease; a primary valvular disease; a myocardial disease (different cardiomyopathies); heart inflammation (myocarditis); sometimes pericardial disease; or even persistent arrhythmias (tachycardiomyopathy). Sometimes even other body systen disorders may severely affect heart function. I made all this extended prescription, because depending on the primary cardiac involvement (cause), will be based the prognostic evaluation. There are several disorders, that may be corrected or maintained under control (tachyarrhythmia, valvular dysfunctions, etc). Could you give more details about your primary cardiac disorder??

(2) Functional capacity in HF patient is of utmost importance, as it may reflect implications of heart dysfunction in everyday activity, body conditioning, and is a useful guide of therapy and prognosis. NYHA class II has a better prognosis than III or IV (has the poorest prognosis, which generally approximates XXXXXXX 1 to 5 years at an optimal scenario). Does your doctor told your NYHA functional class??

(3) Your cardiac ultrasound report is very important to judge about the prognosis, as it reflects direct implications of cardiac performance by underlying disease. Some echo elements: like severe LV dysfunction (very low EF and/or restrictive LV filling pattern), severe valvular dysfunction, RV dysfunction and presence of pulmonary hypertension, in conjunction with persistent arrhythmia: (frequently atrial or even ventricular), reflect a poor prognosis, and show a short life expectancy compared with HF patients missing those echo parameters.

(4) Co-morbidity, like pulmonary, renal, liver, cerebral dysfunctions imply a bad contribution to life expectancy, too.

(5) Patient compliance with the prescribed therapy is very important in deciding prognosis. One of the most important reasons of increased HF patient hospitalisation and death rates is poor therapy compliance.

(6) New therapeutical options, when available, such as percutaneous procedures, permanent assist devices, new drug options, offer a bridge to longer life ecpectancy and better living conditions.

Hope to have been helpful to you.

Feel free to ask me whenever you need. Greetings! Dr. Iliri

Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Ilir Sharka 16 minutes later
Thank-you.the underlying problem is to do with my veins.when they tried to put in a cannula they couldn't get blood out as it was in the right place but the valve kept collapsing.does this help? Trapping was 473 on admission and fell to 250.
doctor
Answered by Dr. Ilir Sharka 4 hours later
Brief Answer:
Wish you a good heath!

Detailed Answer:

Hello again!

As your last concern is of a simple practical nature; you need to discuss with your attending physician on site.

If you have any additional questions to clarify, do not hesitate to ask!

Wish you a good health! Dr. Iliri
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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