Heart Failure and Progression

[Prada47]

Hello

I have posted on this before but couldn't find the right thread !!

Had a good conversation with the HF Nurse about progression of Heart Failure this week.

Background Male aged 71 ( But Mentally around 40 ish ) Heart Attack 1982, No Medication ( nothing ) until 2015. After experiencing Angina symptoms in 2015 CABG X 2 RCA totally Blocked and No point in Bypass. 2018 Stents to open by passed LAD, Heart Failure Diagnosed 2015 after CABG Ejection Fraction 27 % Current Ejection Fraction 43 %

So how long will I live with HF ? The answer was, Heart Failure is progressive and with out a cure being found, it will progress. The Nurse went on to say we all progress at different rates due to Lifestyle and Medication.

So the next question was how will I know it is progressing ?

You will know by your shortness of Breath becoming more difficult to contend with, also your Furosemide won't cope with the Increase of Fluids. When you go for a walk and can no longer quite make the distances you used to.

So we manage this Progression, by monitoring your Weight and Blood Pressure and increasing your Medication to the Maximum you can tolerate. In my particular case Candesartan will be increased to 32 mg ( now 12 mg ) and Bisoprolol to 10mg ( now 7.5mg ) other Medication is Eplerenone 25mg, Furosemide 20mg, Omeprazole 20mg, Clopidogrel 75mg, Asprin 75mg, Pravastatin 10mg, and finally Isosorbide Mononitrate 40mg modified release tablets. Should my H F progress any further after reaching Maximum Dose the next step would be an Artificial Aid ICDs etc. I recently had some stenting done to my Left Coronary Artery but, unfortunately, it didn't make a difference to the Ejection Fraction, (mine is not so poor at 43 %). What the stenting has done is improved things so that I no longer have angina symptoms and I no longer need to use the GTN spray. Both my GP and HF Nurse have both said keep the GTN close by just in case, lol.

The other discussion was about Planning should I ever reach the stage of needing Palliative Care, would I prefer to be at Home or in a Hospice. I would add that I am a long way from Palliative Care, (I hope a very, very long way!)

Finally, the HF Nurse did say a lot of people die of something else long before they reach the Final Stage of Heart Failure!! ( Reassuring ) LOL

This is my honest appraisal of how I understood the discussion to have gone .

I do feel really well at this moment in time.

Regards

[Lhatty]

Thank you for writing this in such detail, it’s such a great help seeing it broken down

[Rosei]

I had my HA in Dec 2016. I feel really well and my medication is 1.5 bisoperol, 2 mg candasartan, Clopidogrel 75mg and ranatadine. It looks like I have a long way to go and I'm 83.

[shopman]

Do you retain much fluid? Only ask as wait until they increase them, 240mg per day is no joke and means I can not plan anything in advance unless I know where the loos are.