Please help!

[unclecraigo]

My husband is a 57 year old male, 6'1" weighing 192, with type 2 Diabetes, and high blood pressure.  On July 23, 2008, he had a massive heart attack, and two days later a CABGx5.  He has since been diagnosed with CHF, and had an ICD implated 2 weeks ago.  He has been admitted to the hospital twice for CHF and another two times in emergency for CHF, with the last episode just last week - in the hospital for 3 days.  These are his last echo results.

MEASUREMENT TABLES

2D measurements
LEFT VENTRICLE NORMAL
LVID ed (chordal) 51 mm 37-58 mm
LVID es (chordal) 44.7 mm 20-38 mm
FS (chordal) 12 % 28-41%
IVS ed 10.8 mm 7-11 mm
LVPW ed 9.9 mm 7-11 mm
Apical 4-Chamber
LV area ed 39.4 cm\S\2 17.7-47.3 cm\S\2
LV area es 35 cm\S\2 7.9-31.5 cm\S\2
LV area change 11 % 31-68%
RIGHT ATRIUM NORMAL
Estimated CVP 10 mmHg --

M-mode measurements
AORTA NORMAL
AoD (root) 34 mm 20-37mm
LEFT ATRIUM NORMAL
LAD 47 mm 19-38 mm
LAD index (A-P) 2.3 cm/m\S\2 <2.2 cm/m\S\2

Doppler measurements
RIGHT VENTRICLE NORMAL
Estimated RV systolic pressure 82 mmHg <30 mmHg

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CARDIAC ANATOMY

LEFT VENTRICLE
The left ventricle was mildly dilated. Overall left ventricular systolic
function was severely reduced. Left ventricular ejection fraction was
estimated in the range of 15 % to 20 %. There was akinesis of the entire
anterior, apical and anteroseptal walls. There was possible hypokinesis of
the basal inferior wall. Left ventricular wall thickness was normal. There
was moderate paradoxical motion of the interventricular septum, consistent
with a post-thoracotomy state.

RIGHT VENTRICLE
Right ventricular systolic function was moderately reduced.

LEFT ATRIUM
The left atrium was moderately dilated.

RIGHT ATRIUM
Right atrial size was normal.

AORTA
The aortic root was normal in size. The aortic arch appeared to be normal.

AORTIC VALVE
The aortic valve was probably trileaflet. Aortic valve thickness was mildly
increased.

MITRAL VALVE
There was mild to moderate mitral annular calcification. There was mildly
reduced mitral valve leaflet excursion. Doppler interpretation(s) There was
severe mitral valvular regurgitation.

TRICUSPID VALVE
The tricuspid valve structure was normal. Doppler interpretation(s) There
was moderate to severe tricuspid valvular regurgitation.

PULMONIC VALVE
The pulmonic valve was not well visualized. Doppler interpretation(s) There
was trivial pulmonic regurgitation.

PULMONARY ARTERY
Doppler interpretation(s) The estimated peak pulmonary artery systolic
pressure was severely increased. Estimated peak pulmonary artery systolic
pressure 82 mmHg.

SYSTEMIC VEINS
The inferior vena cava was normal.

PERICARDIUM
There was no significant pericardial effusion.

Conclusions

Summary
- The left ventricle was mildly dilated. Overall left ventricular systolic
function was severely reduced. Left ventricular ejection fraction
was estimated in the range of 15 % to 20 %. There was akinesis of
the entire anterior, apical and anteroseptal walls. There was
possible hypokinesis of the basal inferior wall. There was moderate
paradoxical motion of the interventricular septum, consistent with a
post-thoracotomy state.
- Right ventricular systolic function was moderately reduced.
- The left atrium was moderately dilated.
- Aortic valve thickness was mildly increased.
- There was mild to moderate mitral annular calcification. There was
mildly reduced mitral valve leaflet excursion. There was severe
mitral valvular regurgitation.
- There was moderate to severe tricuspid valvular regurgitation.
- The estimated peak pulmonary artery systolic pressure was severely
increased. Estimated peak pulmonary artery systolic pressure 82
mmHg.

My question is this.  He feels increasingly worse, rather than better.  He is not sleeping at night, and doesn't eat much, because the least amount of sodium causes him to go into CHF.  How bad off am he, and will this get better?  He is 57, but still has to young boys at home.  He is very worried and the stress is making things worse.  What can I do?

Thanks, Dara