Question about improving heart function in CHF
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Question by Heart Blog viewer:
My father is 80 years old and suffers from advancing stages of congestive heart failure. He has recently worn a 48 hour heart monitor and underwent a chemical stress test to help determine his course of treatment. He had six bypasses a decade ago and has been on Warforin for 2 years. He's been told the the top of heart is functioning at an acceptable level but the bottom of his heart is not working efficiently and is currently operating at 20%.
We're wondering if there is a treatment option or medication that will strengthen the lower heart muscle?
Answer by Kelly:
The standard, evidence based medicine for Congestive Heart Failure and an Ejeciton Fraction (EF) of 20% would include maximizing the following medications: beta blocker (toprol or coreg) and ace inhibitor. By maximizing I mean having him on the highest dose that he can tolerate. Typically, when the EF is less than 30%, his physician should have had a discussion about placing a defibrillator. With an EF less than 30%, there is a high risk of sudden cardiac death and arrythmias. The defibrillator can help to save your father's life if a life threatening arrythmia would occur. I am curious as to what the holtor monitor that he wore showed, if anything. One other thing to mention, is cardiac resynchronization. Sometimes, depending on your father's electrical conduction, a pacemaker can be inserted into the heart to "synchronize" both the right and left side. This will help to improve the top and bottom parts at working together, to make the heart pump stronger. There are specific criteria that have to be met for this to be beneficial.
I hope that helps, let me know if you have other questions.
