What might the options be?

I am a 40 year old male, five-six, approximately 160 lbs.

In the past week, I have been diagnosed with Congestive Heart Failure, Atrial Fibrillation, experienced a myocardial infarction, and then diagnosed with cardiomyopathy (left ventricle).

I am presently on the following medications: Digoxin (250 mcg), Furosemide (20 mg), Zestril (5 mg) and Warfarin Sodium (2 mg).

None of my doctors have discussed any sort of prognosis or long-term treatment plan outside of the medications; attempts to get me into normal sinus rhythm have failed.

What is normal treatment and what might be the protocol for the future?

Thank you,

James Eric Payne
Livermore, CA

[Cleveland Clinic, MD]

Dear James,

Thank you for your question.  Unfortunately, it's a bit like asking how to get from California to New York - there are many different ways to proceed.  The approach we would probably take here would be to proceed with a catheterization and treat your coronary artery blockages based on the results of that test- either medical, angioplasty or bypass surgery.  Next we would attempt to establish and maintain sinus rhythm through medications or other means.  If all else fails then we would consider other possible treatment options including heart transplant.  That's a bit general answer and your doctors will have to tailor your treatment to you.  Let us know if there is anything else we can help you with.