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What Is The Prognosis For Stage-4 Heart Failure?
Question: Hi father diaginosed stage 4 heart failure - one dr said its severe and another was not that worried - confussed i am. Icd machine fitted . Is prognosis poor
stage 4 is definitely something to worry about.
prognosis is guarded and poor.
thanks
prognosis is guarded and poor.
thanks
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
But my concern is he is not symptomatic much so how can be stage 4. He onky gets breathless sometimes upon exertion .
His ejection fraction is 15.
He had bypass surgery 5 years ago following a heart attack and had heart damage then. It seems to have progressed slowly.
He has a icd machine fitted also due to dangerous heart rhythms.
His ejection fraction is 15.
He had bypass surgery 5 years ago following a heart attack and had heart damage then. It seems to have progressed slowly.
He has a icd machine fitted also due to dangerous heart rhythms.
Brief Answer:
should be stage 3
Detailed Answer:
Hi,
Welcome.
This is Dr Sameer, cardiologist from Fortis Hospital.
Stage IV heart failure denotes decompensated heart failure, meaning that patient is breathless even at rest & the compensatory mechanism of body protecting the body from CHF(fluid retention) fails.
15% heart function is definitely very less & if not on proper medication has a poor prognosis due to arrhythmias.
ICD does not improve heart function but only protects against life threatening arrhythmias like VT.
After heart attack muscles of heart die permanently if the arteries are open in proper time. This causes decreased heart function.
Prognosis will be always guarded. I know this sounds very bad but the actual fact is that such type of patients develope heart failure very frequently & life expectancy is less than normal individual.
It is very important to keep a balance between total intake & output and take medicine regularly.
If you have any more question, I'll be happy to help.
Thanks & take care
should be stage 3
Detailed Answer:
Hi,
Welcome.
This is Dr Sameer, cardiologist from Fortis Hospital.
Stage IV heart failure denotes decompensated heart failure, meaning that patient is breathless even at rest & the compensatory mechanism of body protecting the body from CHF(fluid retention) fails.
15% heart function is definitely very less & if not on proper medication has a poor prognosis due to arrhythmias.
ICD does not improve heart function but only protects against life threatening arrhythmias like VT.
After heart attack muscles of heart die permanently if the arteries are open in proper time. This causes decreased heart function.
Prognosis will be always guarded. I know this sounds very bad but the actual fact is that such type of patients develope heart failure very frequently & life expectancy is less than normal individual.
It is very important to keep a balance between total intake & output and take medicine regularly.
If you have any more question, I'll be happy to help.
Thanks & take care
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Ok what is prognosis like would u say approx? Hes 74 and had fluid retention . I dont know why here in uk they saying stage 4
Brief Answer:
Please see the detailed answer below
Detailed Answer:
Hi,
Welcome back.
It could be stage IV. As you are saying he currently has fluid retention, means his body can not remove it by itself & his compensatory mechanism is not working. This means Stage IV. It is actually a clinical diagnosis.
It does not matter much whether heart function is 15%. Prognosis of Stage III & IV are nearly equal. Exact duration is very difficult to say because such patients can develope life-threatening arrhythmia at any time. It could be next day, next month or next year. So exact duration is very difficult to assess.
Rest, keep him happy, make sure he takes regular medication & keep a strict intake of input & output and be sure he maintains a negative balance.
Being happy is another part of treatment as it releases hormones which increase the life expectancy & prognosis.
If you have any more question, I'll be happy to help.
Thanks
Take care
Please see the detailed answer below
Detailed Answer:
Hi,
Welcome back.
It could be stage IV. As you are saying he currently has fluid retention, means his body can not remove it by itself & his compensatory mechanism is not working. This means Stage IV. It is actually a clinical diagnosis.
It does not matter much whether heart function is 15%. Prognosis of Stage III & IV are nearly equal. Exact duration is very difficult to say because such patients can develope life-threatening arrhythmia at any time. It could be next day, next month or next year. So exact duration is very difficult to assess.
Rest, keep him happy, make sure he takes regular medication & keep a strict intake of input & output and be sure he maintains a negative balance.
Being happy is another part of treatment as it releases hormones which increase the life expectancy & prognosis.
If you have any more question, I'll be happy to help.
Thanks
Take care
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
They have got rid of the fluid now. ...he was
On some of these medications like beta blockers since 5 years but looks like still progressed
Right?
Stage 3/4 we looking few years or
Months approx?
On some of these medications like beta blockers since 5 years but looks like still progressed
Right?
Stage 3/4 we looking few years or
Months approx?
Brief Answer:
Difficult to predict
Detailed Answer:
Hi,
Welcome back.
Drugs like beta blocker & ACE inhibitor are very important part of management & improve the prognosis & survival. So be sure he is on both these medications.
Fluid removal is done by drugs called diuretics which include torsemide or Furosemide + Aldosterone antagonist (Aldactone). Antiplatelets are to prevent stenosis of grafts.
Another drug called Digoxin prevent recurrent hospitalization for such patients.
So all these should be there in his treatment regimen.
Coming to prognosis, as I explained earlier, it is difficult to predict. But as he is in decongested (fluid free) state & hemodynamically stable, the life expectancy should be more than 6 months or could be some years if he remains like this. We have seen patients having 15% heart function living till 90's.
So proper medications and supportive care are all he needs.
Hope this answers your query. If you have any more question, I'll be happy to help.
Thanks and take care
Difficult to predict
Detailed Answer:
Hi,
Welcome back.
Drugs like beta blocker & ACE inhibitor are very important part of management & improve the prognosis & survival. So be sure he is on both these medications.
Fluid removal is done by drugs called diuretics which include torsemide or Furosemide + Aldosterone antagonist (Aldactone). Antiplatelets are to prevent stenosis of grafts.
Another drug called Digoxin prevent recurrent hospitalization for such patients.
So all these should be there in his treatment regimen.
Coming to prognosis, as I explained earlier, it is difficult to predict. But as he is in decongested (fluid free) state & hemodynamically stable, the life expectancy should be more than 6 months or could be some years if he remains like this. We have seen patients having 15% heart function living till 90's.
So proper medications and supportive care are all he needs.
Hope this answers your query. If you have any more question, I'll be happy to help.
Thanks and take care
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Hea been guv
Brief Answer:
He will be fine
Detailed Answer:
Hi,
I think you have not typed full question. But he will be fine. Just keep him in negative balance (keep total intake of all fluid around 1.2 ltr or less depending on urine output) & on proper medications he will be fine.
Make sure he eats healthy too and he will be fine.
Thanks
He will be fine
Detailed Answer:
Hi,
I think you have not typed full question. But he will be fine. Just keep him in negative balance (keep total intake of all fluid around 1.2 ltr or less depending on urine output) & on proper medications he will be fine.
Make sure he eats healthy too and he will be fine.
Thanks
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Ok is it poss survival can be more than 12 months ?
Does medication always work though even at advanced stage? Because he has been already on ramapril, asprin, bisoprol for 5 years and now is stage 3/4?
If symptoms persist even on medication then prognosis worser ?
Does medication always work though even at advanced stage? Because he has been already on ramapril, asprin, bisoprol for 5 years and now is stage 3/4?
If symptoms persist even on medication then prognosis worser ?
Brief Answer:
Yes it does
Detailed Answer:
Hi,
All these medications improve the survival but to a limit. Without the medications it would have been very difficult to improve.
But even the body has to respond to the medication and there is a limit where even the best medications fail to work. Symptoms even on all medications prove this thing and yes, prognosis is not good then.
Yes these medications work in all stages and help improve survival and yes complications like life-threatening arrhythmias can occur despite being on these medications.
Thanks
Yes it does
Detailed Answer:
Hi,
All these medications improve the survival but to a limit. Without the medications it would have been very difficult to improve.
But even the body has to respond to the medication and there is a limit where even the best medications fail to work. Symptoms even on all medications prove this thing and yes, prognosis is not good then.
Yes these medications work in all stages and help improve survival and yes complications like life-threatening arrhythmias can occur despite being on these medications.
Thanks
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Do the medications have an effect almost immediatley?
Brief Answer:
Month
Detailed Answer:
Hi,
These all drugs take months to show their full effect. They prevent remodelling of heart by various methods.
So immediately their is no much benefit.
Thanks
Month
Detailed Answer:
Hi,
These all drugs take months to show their full effect. They prevent remodelling of heart by various methods.
So immediately their is no much benefit.
Thanks
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Yogesh D
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