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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Chronic heart failure, high blood pressure. Pain in the left arm and neck. Recovery chances?

Hello Dr. My mother-in-law is 87 years old, has had chronic heart failure for at least 10 years, has had high blood pressure for over 35 years. Now she is havaing "episodes", we think it might be angina. She is with hospice, in my state they come into your home a couple of days each week. Her episodes include pain which she says is in the heart area and sometimes is in her left arm, or her neck. She has NO pain tolerance at all anymore. We thought she was going to pass away soon, as that's what the hospice nurse said, but she seems to go on and go on. I don't like to see her in pain, which she is. What is the life expectancy of this type of patient? She has ben having anywhere from 2 to 6 episodes in a 26 hour period. Thank you.
Sat, 27 Jul 2013
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General & Family Physician 's  Response
Life expectancy can never be predicted be it a cardiac patient,non cardiac patient or even a normal person.At this age,she needs a comfortable life,thats all.Too many restrictions,too many investigations and too many medicines may not be fair to her.She needs to be just on sufficient medication to keep her BP and heart failure under check.Angina is not the only cause for chest pain associated with left upper limb pain. Musculoskeletal pain can also occur like this.The latter is usually associated with movements of arm or neck.It can occur more frequently and at a lesser intensity.In that case some mild long acting analgesics will suffice.In case its angina also, she will require just sub lingual nitrates during the pain episodes.The exact distinction between the two can only made by clinical examination and full history and hence physician consultation would be helpful.
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Cardiologist, Interventional Dr. Shafiq Ahmed's  Response
My own feeling from the history you posted is that her arm pain may be coming from her musculoskeletal system od left hand.
can you let me know what medication she is taking.
Also let me know if she feels pain if one moves her left arm.
Is she diabetic.
Can nurse can check her pulse ,blood pressure and let me know.
Is she mobile and how active she is.
87 doesn't mean to me end of life. I am positive if I have all above information I can be of help
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