CARDIAC ARREST

[vikrambakshi]

Dear Doctor,

I AM AN ASIAN-INDIAN MALE OF 45 YEARS OF AGE-RESIDING IN U.K.
I HAD A HEART ATTACK IN INDIA IN MAY 2003, AND ANGEOPLASTY AND STENTING WAS DONE.MY LVEF CAME DOWN TO 32%.
AFTER THIS FIVE YEARS PASSED WITHOUT A SINGLE PROBLEM, THOUGH I WAS TAKING THE RECOMMENDED MEDICINES.

IN NOV 2008, I HAD A CARDIAC ARREST WITHOUT ANY WARNING AND WAS LUCKY TO BE REVIVED BY THE AMBULANCE TEAM.IN THIS PROCESS I GOT BRAIN INJURY ALSO.AFTER ONE MONTH I WAS DISCHARGED FROM THE HOSPITAL WITH ICD FITTED TO ME.MY LVEF HAS COME DOWN TO 21%.

I AM TAKING-ASPRIN/CARVIDILOL/CLOPIDOGREL/ATORVASTATIN/
AMIODERONE/RAMIPRIL/LANSOPRAZOLE.

MY QUERRIES ARE-

-WHY DID THIS CARDIAC ARREST HAPPEN.

-HOW DID THE LVEF GO DOWN FROM 32% TO 21% OVER FIVE YEARS DESPITE TAKING REGULAR MEDICATION.

-IS ICD ENOUGH SAFE GUARD FOR THE FUTURE

-WHAT DOES LIFE HOLD FOR ME REGARDING THE PROGRESS OF MY HEART CONDITION. WHAT NEW PROBLEMS WILL/CAN COME, ARE THESE AVOIDABLE.

-ARE THERE SOME MORE TREATMENTS-(LVAD OR CRT OR EECP)ETC.CAN THESE BE GOOD FOR ME

-IS STEM CELL TREATMENT RIGHT FOR ME.IF YES HOW TO GO ABOUT IT AT WHAT COST.

RIGHT NOW TODAY I STAY AT HOME AND FEEL NORMAL-THEN WHAT / WHEN WILL BE THE PROGRESS OR DETERIORATION IN MY CONDITION IN THE COMMING TIME.

WILL BE VERY THANKFULL FOR YOUR VALUABLE REPLY.


VIKRAM BAKSHI
TELEPHONE-
0044-121-3578424

[kenkeith]

The ICD is meant to maintain a normal heartbeat rate, and prevent irregular beats.  The irregularity can cause the heart to go into an arrhythmia or cardiac arrest.  The underlying cause is an electrical impulse disarry possibly due to obstruction of electrical pathways to the heart cells.  The disarry can be due to an enlarged heart chamber, damaged heart muscle, etc. Many people lead a normal or near normal life with an ICD.

An EF is an esitmate of the fraction of blood pumped out of the left ventricle with each heartbeat (normal is 50 to 70%). Usually, the problem is due to damaged heart cells that weaken chamber contraction to pump blood.  You have a history of blocked coronary vessels, and the blockage may have caused heart cell damage by lack of blood/oxygen to the heart tissues for a period of time.

EECP helps some individuals (70%)  if one has blocked vessels...but medication to dilate vessels is the first option.  Stem cell therapy could help restore damaged heart muscle...I don't have any information on the status of research or therapy.  

It is difficult to establish a prognosis for a heart condition because there are so many variables that include the general health otherwise, life style, diet, exercise. etc.
Six years ago I had enlarged left ventricle, an EF of 19 to 29%.  Currently with medication my heart is normal size and  EF is 55%.