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50% of heart muscle dead
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Kathy59 posted:
My husband had a heart attack at age 48 - he is now 58. It was pretty severe, very painful, left arm swelled up he eventually passed out. He was a very healthy person, ate right but smokes like a freight train. He did not go to the doctor until age 55 because of chest pains. No high cholesteral, no high blood pressure and no blockages. After all the tests they told him that 50% of his heart is dead. He has CHF, heart disease. They told him that he needed to be on the transplant list - but he will not quit smoking. they wanted to give him a defibrillator but he is active on the weekends and is scared that it will shock him while he is riding his motorcycle, which is the only thing he can do, pretty much now. His medications make him feel good - but I know they are just a band-aid. My question is - how long can you survive with 50% of your heart muscle dead - They cannot do surgery because of the scar tissue and the damage it has done.
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cardiostarusa1 responded:
Hi:

"How long can you survive with 50% of your heart muscle dead"

This is a variable, as everyone is unique, with each and every case/situation being different.

"But he will not quit smoking"

Do the absolute very best that you can to convince him to quit.

"They told him that he needed to be on the transplant list"

As reported, some cardiac patients, who were extremely ill, and who had an LVAD (heart pump to assist the left ventricle) implanted, were able to stay alive long enough until a heart became available, or were able to avoid a heart transplant completely, as being on an LVAD (and then having it explanted/removed) helped to reverse some of the damage done to the heart, allowing one to live as near a normal life as humanly possible.

"They wanted to give him a defibrillator"

It is often said that an implantable cardiodefibrillator (ICD) is like having a rescue squad inside your chest. As demonstrated in clinical studies (patients meeting the current criteria), in some cases, those with a low (moderate) or very low (severe) left ventricular ejection fraction (LVEF), an ICD can improve the outcome (especially if the heart's electrical system goes haywire).

Some individuals who have a low (moderate) or a really low (severe) LVEF feel fine and function well, while others do not. It is important to know/keep track of the LVEF, the single-most important clinical indicator of heart function, how well the heart is pumping.

Normal resting range is 50%-75%. Under 50% enters into the realm of dysfunctional territory that goes from mild to moderate to severe heart failure.

Understanding Your Ejection Fraction

http://my.clevelandclinic.org/heart/disorders/heartfailure/ejectionfraction.aspx
**To get a decent estimate of LVEF, a MUGA scan is reported as being the most accurate of the non-invasive imaging.

Pertinent excerpt from article by Richard N. Fogoros, M.D.

When is the MUGA scan more useful than other heart tests?

The advantages of the MUGA scan over other techniques (such as the echocardiogram) for measuring the LVEF are twofold
. First, the MUGA ejection fraction is highly accurate, probably more accurate than that obtained by any other technique. Second, The MUGA ejection fraction is highly reproducible. That is, if the LVEF measurement is repeated several times, nearly the same answer is always obtained. (With other tests, variations in the measured LVEF are much greater.)

.

As applicable, in some cases, along with a doctor recommended/authorized exercise regimen (unless contraindicated), LVEF can be increased, sometimes substantially, by customizing/tweaking prescription drug-therapy (e.g., Coreg, which showed, back in its clinical trial days, that it could boost LVEF in some individuals) and supplemental (complimentary or integrative medicine) therapy, as deemed applicable.

Just one example of complimentary medicine is the use of the supplement Coenzyme Q10 (CoQ10 or ubiquinone, a vitamin-like substance) for heart failure (though currently not scientifically proven, some doctors may advise the patient to give it a try) which may/can (i.e., along with doctor directed prescription drug-therapy, and with the doctor knowing about any supplements being taken) help to improve LVEF in some, with other supplements sometimes added to the mix.

WHAT HAPPENS AFTER A HEART ATTACK (and down the road) mainly depends on what specific area(s) of the heart muscle (myocardium) were damaged (infarcted), size and depth of the damage, and if there has been any previous damage or other serious/severe heart condition(s) exist.

Noteworthy, though the damage done after a heart attack is seen as being permanent/irreversible, some ongoing clinical trials are showing promise for making heart damage/heart failure reversible.

Best of luck to your husband and you down the road of life.

Take care,

CardioStar*

WebMD member (since 8/99)



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Kathy59 responded:
Thank you so much.
 
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Kathy59 replied to cardiostarusa1's response:
Thank you so much.
 
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cardiostarusa1 replied to Kathy59's response:
You're welcome.

Take good care,

CardioStar*



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