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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Left Ventricular Dysfunction

sir my mother age 52.

Principal diagnosis: DM/CAD/OLD IWMI/SEVERE LV DYSFUNCATION/SVD-RCA ATTEMPTED PTCA/STENTING TO RCA-ABANDONED.

HISTORY: Admitted for PTCA/Stenting CAG and revascularizatiom. CAD/OLD AWMI/Sev.LV dzsfunction with SVD-RCA.

No history of HTN/DM/COPD/TIA/CVA/Drug allergy.

Bowel and bladder habits normal.

On examination:

HR 70/MIN

BP 120/70 mmHG

CVS-S1 S2 +

RS-naormal.
Tue, 16 May 2017
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Pulmonologist,  's  Response
Hello
Thanks for posting at HCM.
Going by your description it is evident that your mother has sustained a heart attack in the inferior wall of the heart which is supplied by the RCA. The RCA which was blocked and caused he attack was attempted to be stented but was not possible due to chronic total occlusion or calcification. Because of the heart attack, the heart muscle in the inferior wall of the heart sustained damage, that's why the severe LV dysfunction. Since RCA could not be stented, there is only the option of medical management. Bypass surgery is done only if there is involvement of the LAD.
So she has to be on medications like two blood thinners , cholesterol lowering medications, diuretics to decrease load on the heart and other medications like beta blockers which prevent the remodeling of the heart after a heart attack.
She should do well if she is compliant on the medications. Since RCA could not be opened and the past of the heart supplied by the RCA is already damaged, there is no need to re attempt the stenting.
Wishing her good health.
Regards
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Suggest Treatment For Left Ventricular Dysfunction

Hello Thanks for posting at HCM. Going by your description it is evident that your mother has sustained a heart attack in the inferior wall of the heart which is supplied by the RCA. The RCA which was blocked and caused he attack was attempted to be stented but was not possible due to chronic total occlusion or calcification. Because of the heart attack, the heart muscle in the inferior wall of the heart sustained damage, that s why the severe LV dysfunction. Since RCA could not be stented, there is only the option of medical management. Bypass surgery is done only if there is involvement of the LAD. So she has to be on medications like two blood thinners , cholesterol lowering medications, diuretics to decrease load on the heart and other medications like beta blockers which prevent the remodeling of the heart after a heart attack. She should do well if she is compliant on the medications. Since RCA could not be opened and the past of the heart supplied by the RCA is already damaged, there is no need to re attempt the stenting. Wishing her good health. Regards