conjestive heart failure

[James B]

My mother has developed conjestive heart failure. She is 85 years old. Up to three weeks ago she was totaly independent, now she is confused and don't seem to want to even get up, she has trouble following direction also. Her doctor say's when her lungs had fluid in them that she wasn't expelling all the carbon mioxide and caused the confusion, also that getting the fluid level in her to where her heart can handle it and keep her from dehydrating is like walking a tightrope.
1. Do you think she can regain all her mental capablities.
2. Her E.F. is 50 on echo, with an almost normal E.F. Why is she having problems with fluid buildup?
3. Any general information you can give me on CHF and the elderly would be appreciated.

[CCF-M.D.-MJM]

Hi James,

Sorry to hear about your mothers recent health problems.  This doesn't sound like a typical case of heart failure.  We can generalize heart failure in two categories: systolic and diastolic.  Systolic heart failure is the one that is usually talked about.  Patients usually have a lower ejection fraction and the traditional symptoms of heart failure like swelling in the legs, trouble breathing when lying flat, shortness of breath with exertion.  Diastolic heart failure occurs with both normal and abnormal ejection fractions.   It sounds like they are diagnosing  her with diastolic heart failure.

Short of having a stroke or having a prolong period without enough oxygen, I haven't seen any cases of heart failure that cause normal function and then profound abnormal function without some sort of dramatic change like a recent heart attack, stroke, renal failure, etc.  Did she have an elevated carbon monoxide level?  

I will admit, the story doesn't make complete sense to me, but it may be pretty complicated.  She may just have significant diastolic dysfunction with only subtle symptoms of heart failure prior to this episode.  If you are concerned, a second opinion can sometimes help.

I wish you and your family the best and hope this helps.

I hope this helps

[James B]

She had a raised carbon monixide level, shortness of breath with exertion or lying, swelling ln legs and face-neck, no stroke, no heart-attack, no blood clots, had just had shingles, and then penumonia, and now this.

[James B]

Also blood preasure has been 110 to 130 top 36 to 44-45 bottom

[donray]

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[Babycakes1]

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