life expectancy of chf patient with 10% injection fraction

[sherry williams]

Last week my father-in-law was hospitalized and tests were done on his heart.  He was told his injection fraction was 10%.  He has enough strength to tranfer and that is about it.  His doctor said he really hadn't worked with alot of patients in his condition.  What we as the family are trying to figure out is whether a person normally lives many months or even years with this condition (then we will have to place him in a nursing home) or if the odds are that he will likely only survive weeeks or a few months, (then we can try to arrange 24 hour care at home).  Being at home is very important to him at this time, however, my mother-in-law is also almost 70 years old and we are terrified that caring for him for an extended time would be damaging to her.  We want what is best all the way around.  And, as a family we will care for him at home if at all feasible.  We just don't know anything about injection fractions and how significant it is to life expectancy.  And, unfortunately, neither does our doctor

[CCF-M.D.-CRC]

Dear sherry,
Ejection fraction (EF) is a measurement of the pumping action of the heart.  Normal EF is between 55 and 70%.  Mild decrease in 40-50%; moderate 25-35% and severe <20%.  Mortality is directly related to EF and persons with very low EFs have a much higher risk of death.  The 5 year mortality for persons with an EF of 10% is upwards of 90%.  However, it is difficult to determine for an individual how long they have to live.  If your father-in-law has determined that he does not wish to have agressive treatment you may wish to talk to a hospice service.  They are able to help with arranging in-home end-of-life care as well as helping the family deal with issues that arise.

[debra21784]

Sherry ,Iam sorry to hear about your father's serious illness.I am a little perplexed about your comment about his doctor not knowing about ejection fraction.Is the doctor a cardiologist?
Have you taken him to a teaching/research /academic medical center that has a heart failure program for evaluation?
I certainly would look at that route to see if there is something more difinitive for your family to help make decisions.

[sherry williams]

No, our doctor is not a specialist.  We did have him sent to a hospital in Kansas by ambulance and they did the injection fraction test and a test on his stomach that said his stomach took over 137 minutes to digest his food?  But, he was already brought back to our hospital before we got the test results back.  Do you think a cardiologist could work with him?

[Richard_W]

The ejection fraction is quite important.  He definitely should be under the care of a cardiologist and he/she can provide an informed prognosis.

[debra21784]

HE NEEDS A CARDIOLOGIST, the ejection fraction tells you about the pumping ability of the heart. Why didn't they call a cardiologist? There has to be a large academic medical center in your area that has a good cardiology department.Get your dad to a good one.You can access a listing of physicians on line through the American Medical Association as a starting point or call your local board of MED-CHI or physician liscensure board.
What meds is he currently on?
Sherry,ejection fraction has nothing to do with the stomach.This is heart failure and he needs a cardiologist.Sometimes patients can be controlled medically in supervised heart failure programs and life expectacny can be extended

[pikamom]

Yeah, I'm surprised a cardiologist wasn't called in. Definitely get one, things can be done to help heart failure. My uncle just recently was hospitalized with heart failure and 22 quarts of fluid was drained from his body, I believe my mother said 30 pounds! He's feeling so much better. Does your father have an underlying illness such as cancer that's causing his heart failure? It's important to get this all sorted out.

[debra21784]

Call St.Lukes Medical Center in Kansas.They have a relatively large cardiac service department including heart failure programs,cardiac surgery ect.Get your father an emergent appointment

[sherry williams]

We are going to contact St Lukes today.  I spoke to a doctor in Lebanon Missouri who told me about a new pacemaker available that he thought could very well help.  Our doctor in Hutchinson had also heard of this new pacemaker but said it was a really new thing and he didn't think it would do much good and thought that, even though it was a pretty simple procedure, the risk of infection or poking an artery probably wasn't worth it.  However, I am going to do like you said and find a cardiologist at St Lukes and see what their opinion is.  Thank You all

[debra21784]

Ask what his underlying cause of heart failure is.Pacemakers assist or control the rythmn and rate of the heart if it is beating too slow,too fast or there is a degree of heart block(all the impulses are not getting through).Usually heart failure is linked to things like structural defects, hypertension or  defective vales causing the heart to hypertrophy(enlarge)or any other condition that waekens the heart muscle and prevents the heart from beating adquately to supply blood to the body.Sometimes heart failure can also come from a infection that attacks the heart such as endocarditis.Ask questions, ask them to grade the heart failure as well using a scale of  I II, II, or  IV.He should probably have an echo,chest X-ray possible cardiac cath,EKG,aterial blood gases, cardiac enzymes
Call today for an appointment in the heart center or go to the ER if necessaryat St.Lukes or similar facility.

[sherry williams]

Thank you so much for giving us some insight and guidance.  I must say we were overwelmed and lost at what to do.  It helped to have your input as a way to focus!!!

[Lyn2]

Wow. What alot to have to deal with all at once.  Obviously, there is no question that he needs to see a specialist in heart failure.  The doctor that you spoke with mentioned a pacemaker that may help.  There is a new type of pacemaker called a biventricular pacer that specifically helps patients who are in heart failure.  Certainly don't give up options until you have heard them from someone with a great deal of experience.  Do not rely on someone that does not have that type of expertise, because they may not, and in your father's case do not know the latest advances in treating heart failure.  Good Luck!

[Not a Doc]

You did not specify exactly where you lived but you had spoken with a doctor in Lebanon.  St. John's in nearby Springfield has an excellent cardiac program.  I would recommend Dr. Wiggins if this is in your area.

[Richard_W]

Dr. Wiggins is an electrophysist as I recall and is well regarded. He can map the heart very well.  His partners, Dr. Steven Allyn and Dr. Ronnie Smalling are very highly regarded cardiologists.

[Not a Doc]

I am impressed with your knowledge of physicians in my little corner of the world.  We have a top-notch cardiac program for a hospital not associated with a teaching facility.

[fraser1]

My husband is a 43 yr. old pacemaker patient.  He has had 2 previous open heart surgeries, 1989 & 1990 to correct extra pathways, called WPW (Wolf-Parkinson-White Syndrome), and after the second surgery, was left with total heart block,(third degree)and that is why he is dependant on the pacer.  His most recent pacemaker, a Guidant dual chamber, was inserted Aug. 2000 and was fine until July 2001.  Since that time he has been fatigued, the heart shows symptoms of congestive heart failure, and his injection fraction is 25% as of March 5, 2002.  (It was 35% in Nov. 2001)  We are so discouraged since his conditionm has made NO progress since last July.  He is on Prinvil, Metroprol, Lasix, Magnesium, and potassium, as well as an aspirin a day, all to no avail, although I guess the lasix keeps the fluid off him). Dr.s do not seem concerned at the loss of injection fraction rating in 4 months, and we do not understand why.  Doesn't that seem low to you for an active, yet very fatigued , 43 yr. old?  We have 4 small children, he works full time, and we need him to feel better!! ANYONE with ANY helpful info would be appreciated.  We live in Michigan, but are considering Cleveland Clinic next.

[Richard_W]

I would defintely go to the Cleveland Clinic if I were you.  At his young age he needs the most competent heart management he can find.  My wife was at 25% after her heart attack but with the right management and change of medicine her EF was last up to about 55% and she now lives a normal life.  Previous to this her blood pressure ran out of control and was not aggressively treated.  This caused her heart attack.  Good luck!!

[sherry williams]

Please, have your husband go to a specialist NOW!!!  We just  got another phone call in last night.  My father-in-law has taken a turn for the worse and is retaining fluid despite the high doses of lasix and he is talking like he is at work.  He still knows people but he thinks he is at his office and is talking out of his head.  He refused aggressive therapy because he thought they just wanted to use him as "a guinea pig".  Now, i'm afraid it is too late.  Do not wait like we did.

[leon3jane]

Just want you to know I'm praying for you and your family. My husband is 41 and has DCM and CHF. I know what you're going through. Let us know how you are.
Jane

[sherry williams]

GOD BLESS YOU!!!! And thank you so much for your prayers.

[Aby]

My father is 68 and has had open heart 3 years ago and after that he has gone in and out of A-Fib.  He is a diabetic and has CHF.  This past week he had his 2nd heart cath it was after that we was told he has a 25% injection fraction and one artery is completely blocked, one is 90% blocked and the other one is OK and there is an infarct with and anyourism.  The heart doctor said open heart is not an option and this would have to be taken care of by regulating his medicines. Is there any other options?

[patte]

I am concerned for my father's prognosis. Last year he was diagnosed with ESRD with subsequent dialysis 3 times weekly. In February of this year he began experiencing shortness of breath and fluid in the lungs. The renal doc diagnosed pulmonary edema secondary to unknown. It is now April and the doc tells us he has an EF of 20% per 2-D Echo. He had 5-vessel bypass surgery in 1991. What does this mean? Can the EF be fixed and can closing down a bypass graft cause this drop in EF. Two years ago his EF was 50% per adenosine stress test. He is not diabetic and suffers renal failure due to long term hypertension. I am worried and have made an appointment with his cardiologist. Thank you for any input. Patte

[Mike123]

Can alternative means such as CoQ10 or others help improve Ejection Fraction?

[orea]

A related discussion, heart was started.