20% Heart Function

[nikinakinoo]

Hello
Following an appointment with the heart failure clinic today with my father who is 67. We were informed he has had 20% heart function since suffering  a stroke in November 2007. We were told his heart is 'backing up' and he is retaining too much fluid. His Bisprolol dosage has been increased from 1.25mg to 2.5mg with target dosage of 10mg intended to be reached gradually. His furosomide dosage was also doubled. Could anyone be kind enough to explain the implications of this and or a prognosis and whether or not surgical intervention is an option? We could not ask these questions in my father's presence as he 'does not wish to know' we recently lost our mum and he is very depressed.
Thank you for your attention
Nicola

[Rosasdaughter]

NIkolas

My mother just got a heart attack on Saturday, she is not on 20% heart function.  How is your dad with his 20% heart functining.

I will like to know if anybody knows the prognosis on a patient with 20% heart fucntion.
Please help!
Rosa

[tacolino]

Hi there. Your father has had a serious MI previously & a stroke 9 years ago. The 20% Heart function is the figure for your fathers EF ( The EF is the Ejection Fraction) Its a term used for the amount of blood pumped with each beat. The average EF is 55% - 70%. While 20% is not great, its not the worst number. The doctors increase in meds is intended to try and stabilise/ improve the heart failure your dad has. The diuretic will help reduce Edema and this will help. The Bisoprol is a beta blocker. This slows the heart down a bit. How are his BP numbers? Of course your mothers death will be having a major impact on his feeling of wellbeing and also possibly making him feel he is worse than he actually is. He may feel  vulnerable , its to be expected. The EF of 20% can be debilitating for some people, while others can go on relatively normally with 20% EF. The situation can sometimes improve a bit too. The meds may do this, so you need to be a bit patient. Your biggest challenge is for you all to come to terms with your mums passing. Especially so for your father. Help in this area may be a worthwhile exercise. Hope you dont mind me suggesting this. The family are also probably paranid, fearful for the future  and full of fear at the vulnerability of your father right now.
To a degree hes probably giving up inside after the huge loss suffered. Try to help him and work on improving his mind set going forward. Hope this is not too rambling. Keep in touch

[nikinakinoo]

Thank you for your prompt response and comprehendable explanation of my father's condition. The information you have provided will greatly assist me to explain the situation to my siblings.  
Please accept my apologies as I failed to mention the underlying cause. My father sustained a massive heart attack in November 1991 which was the onset of his heart condition. Following the MI  and resultant angiogram the cardiologist commented that my father has 'the heart of a lion' to have survived the attack and have the level of damage he had sustained. We were informed that 4 out of 7 valves had suffered damage. Since the attack he was medicated, reviewed regularly and suffered occasional angina attacks up until he suffered the stroke in November 2007. I am informed that due to our rapid response to the symptoms he displayed that we prevented a much more serious outcome. He was given a massive dose of aspirin by the paramedics in attendance which prevented total paralysis of his right side as the stroke affected the left hand side of the brain. At present he suffers with cognitive tasks,  memory, recollection, speech etc. I hope this helps and once again thank you ever so much for your time attention and kind response
Bless you
Nicola

[kenkeith]

Sorry to hear about your family probems and father's condition.

From your posted information, your father's heart is only pumping into circulation about 20% (normal is 55 to 75%) of the blood volume received from the lungs.  As a result more blood/oxygen is received from the lungs than the heart's ability to pump causing blood to backup into the lungs and fluids leak into the tissues (pulmonary edema) also medically referred to as congested heart failure (chf).  Furosobide is a diuretic to help rid the system of excess water as the kidneys are producing more fluids because the cardiac output is low (kidneys are reacting normally believing the system is losing blood)...

Usually, the reason for the failure of the heart to pump adequately is due heart muscle damage.  Heart muscle damage can happen with ischemia (lack of blood flow) causing heart cells to die from a myocardio infarction (MI) or heart attack and that can happen without symptoms (that happened to me...hospitalized with chf).  The stroke happens due to lack of blood flow or pressures rupture the small vessels, etc.

The prognosis depends on the underlying cause and the treatment thereof but I don't know the implication of a stroke for recovery (may require physical therapy).  Medication can help strengthen the heart's contractions and reduce the heart's workload by dilating vessels.  Unless your father is having severe chest pains there may be no need for an operation, but if there is valve insufficiency causing low cardiac output, then an operation may be recommended.  Otherwise medication, healthy lifestyle, diet, exercise, etc. may be all that is necessary as well as therapy for a stroke if necessary,