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End Stage Cardiomyopathy?

Does anyone know how a doctor diagnosis a person with End Stage Heart Failure for Cardiomyopathy?  How do they know that it is End Stage?  I have had heart disease for 12 years now and since my ejection fraction dropped once to 25% (and it has done it once before but I came back up to 40%), how is it that they all of the sudden diagnose me with End Stage Heart Failure.  I am just curious that there may be a certain criteria to this diagnosis.  Can anybody shed some light?  Thanks in advance.
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Avatar universal
Thank you for your reply.  I don't see how they can call me end stage then since all the fluid that collected in my lungs and tissues has been extracted with diuretics etc.  I do have minimal breathing problems but I was a smoker for over 30 years, quit a month ago and have COPD and asthma but my breathing problems have greatly decreased since I quit smoking and since the fluid is mostly all gone.  I still have to take diuretics every day but I thought everyone that got the congested heart failure did.  Do they ever take the "pee pills" away?  Wow, sorry, couldn't resist that.  I am still getting around pretty good, get tired easier but that happened last time I was in heart failure.  I am hoping to pull myself back out of this with the supplements and those nasty beta blockers.  Being on a sodium and fluid restricted diet is hardest of all for me since I love salt and drink a lot.  It probably wouldn't be so hard except I already control my diabetes with a restricted diet and it is hard to find things I can eat that don't effect my heart or my diabetes.  Wow, it is a  lot of work just keeping my diet straight.  Again, thanks for your reply, it makes me feel more positive about my outcome.  They were trying to push me to have a heart transplant, defibrillator and/or valve surgery but I am not having dangerous arrhythmias yet and I feel well enough that I don't want to rush anything with a transplant.  I feel I am giving myself only another 10 years (at most) with that and I am only 44 years old.  Any other information you might have would be greatly appreciated.  Take care and I hope you get to feeling better also.
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367994 tn?1304953593
Clinically end stage heart failure happens when the heart contractions are weak and blood from the lungs back up into the lungs and fluids leak in the lung tissues causing pulmonary edema. I had mild edema (congested heart failure) and my heart was strong enough, with treatment, to recover. End stage would be a heart so weak as to  cause breathing problems with very little exertion and possibly no exertion, dry coughing, possible chest pains, easily fatigued, bedridden, and very susceptible to cardiac arrest and that would be the finality.

An EF below 30% is considered heart failure range, but with treatment to reduce the heart's workload, etc., 30% or less may be sufficient to live with reduced activities, but untreated a decline can be rapid causing heart muscle damage and further reduction of the heart's contractility.    
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Avatar universal
Maybe this will help you understand. There is the New York Classification which runs from a Grade I to a Grade IV. A Grade I heart patient has no real symptoms of heart disease. A Grade II patient has some symptoms, Grade III has symptoms with activity and a Grade IV (end stage) has symptoms at rest
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187666 tn?1331173345
I know of people who have improved their EF in time with proper meds and diet. So don't give up.
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Avatar universal
I am very sorry to hear of your father's passing.  Mine passed 2 years ago from a massive heart attack, heart problem run rampant on my Dad's side of the family.  I hope that I fool the doctors also, I am scared to beat all.  I am complying with mostly everything they are recommending from low sodium diet to fluid restriction to taking beta blockers, which is something they never wanted to give me because I have COPD.  I am also taking supplements that the cardiologists do not support such as coenzyme q10 and taurine.  I hope I can beat this thing and bring my ejection fraction back up from 25% to 40% at least, which will take me out of heart failure for a while.  Thanks for your reply, I was beginning to think I wouldn't get a reply from anyone.  God Bless you and I hope things go better for you in the future.

Sincerely,
Vicki
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187666 tn?1331173345
I wish I knew how they decide that. My Dad was diagnosed as being in end stage heart failure back in '06. They even put him on hospice care. The hospice nurse came once a week to monitor his medications, change them as needed. Funny thing? His heart stabilized and after 6 months they took him off of hospice care. He did finally pass away in Aug. '08 but it was from lung cancer that had spread throughout his body.

It would be good to know how they decide end stage because my Dad fooled them all.
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