HF or not HF - That is the question!

[nymima01]

GM everyone! I write here for my mother who is 93 yrs old. She has a pacemaker and we see a EP every 6 months to check on her status and the status of the battery life in the PM. For a few years now, he has “intimated” that my mother has HF and valve problems. She also has tachycardia and edema in her lower legs, and breathlessness. We also see a new cardiologist now and she had an echo done on my mother and venous tests for her lower extremities.

Soon after the tests were done, we go back to the cardio and she tells my mother that everything looks “good”. Since we never really knew the status of her “supposed heart failure”, I asked the doctor what stage the Hf was at. She shook her head and said that my mother is not in HF! She said that she has valve problems with aortic stenosis and some mitro valve regurgitation. But she is not quite in the “moderate” stage yet, so it doesn’t warrant valve replacement or intervention at this time. So we will wait until she is around 95 yrs old to intervene with the valves? I asked the cardio if they do this sort of surgery on someone who is 95 and she said “Yes! This is why the surgery, the way they do it now, was invented! It’s meant for the elderly so we don’t have to leave them in valve failure!” “But your mother is not at that stage yet, so we will continue to monitor her.”

In the meantime, her PCP put her on spiroactone (sp) and increased her lasix from 40 mgs a day to 80 mgs a day for one week. Then she was ordered to dropped down to 40 mgs again and stay on the spiroactone for now. It seems to be helping somewhat, but she is getting breathless again. I’m thinking she needs to increase the lasix, for a few days, and I have a call into her PCP.

My question is this: Her EF is at 50% - which astounded me because I’m thinking the worst according to her EP! But she is seriously suffering with fluid retention again. So is it ONLY her valve problem that is causing this? She also has had afib for over 30 yrs now, but she doesn’t feel the afib nor the tachycardia anymore. (Thank goodness). Except when she is breathless I guess. Is her valve problem the source of her fluid retention, breathlessness and fatigue for most days? And does anyone know of a 95 yr old patient who has under-gone valve replacement or some sort of valve intervention? I am skeptical. Also, her battery may have to be replaced then too! Two doctors - two different stories.