The Right Coronary Territory is Non Viable and he would therefore not benefit from PCI to the native RCA and I have explained the situation to him. ( which he did ) He does have Disease in his LAD which goes on to supply a large septal and diagonal territory and the MRI scan confirms three segments of ischaemia in that territory. I have therefore explained that I will treat his proximal LAD, which supplies the large diagonal and large septal territories instead of the RCA. His symptoms are clearly getting worse and I have therefore increased his Bisoprolol to 5mg morning and 2.5mg evening. Continue Candesartan at 16mg Eplerenone 25mg Furosemide 20mg ISMO 60mg Asprin75mg He does have an EF of 43 % ( at the clinic I was told 46% but hey Ho what 3 % amongst friends ) Letter ends " I have placed him on my waiting list for PCI to his proximal LAD to revascularise the Diagonal and Septal territories " Feel it's all moving in the right direction !!! ps anyone know if 43 % EF warrants being under a HF Nurse ?? Regards Frank W
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Prada47
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Hi Frank, I think a number of factors are taken into consideration to be under the care of a HF nurse. Also, I don't think every area has them. I know of a number of people with HF who've never had one. Think you need to speak to your GP/cardiologist x
I'm not too sure how the HF nurse thing works. I imagine my ejection fraction is still way below your current score (as I've said before, my consultant is not fussed about it as a measurement so it hasn't been mentioned for years!) and I no longer hear from my HF nurse - everything has been stable for such a long stretch, so she's taken me off her list of patients. But I am still able to phone her if I have any questions or feel unwell or want to adjust meds etc. Thinking it maybe does vary quite a lot from region to region? Have you had a HF nurse at all where you are now? If so, maybe give them a call and ask how it works. Otherwise your GP or cardiologist probably. I'd be interested to hear what you find out.
Hi Frank W. Quite the report! It can feel as if you are being spoken to in another language. It sounds like you just have the one question though. A normal ejection fraction is 55% or greater. Some might say your EF is reasonable, but I would suggest trying not to focus on the number but your symptoms and medications instead. One role of the HF nurse is to do what we call optimise your medications. This means the right dose for you that improves symptoms without side effects. The goal of this is to reduce the workload of your heart as well as improve your symptoms. Based on the information you have shared I believe a HF nurse can help you and I suggest having a chat with your GP or cardiologist for a referral.
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