LV EF 20%-Written Report

[Freddie]

I have the written report in my hands as I type. There are 4 pages, this is what it reads (I've put it in point form):
patient - mother-in-law, 80yrs old

- Significant left ventricular systolic dysfunction with an EF of 20-25% and multiple regional wall motion abnormalities consistent with ischemic cardiomyopathy.
- extremely poor left ventricular function consideration to full anticoagulation for of thromboembolic events needs to be strongly considered. Target of 2.0 to 3.0
- has some pedal odems? maybe its edema's?
-dyspnea? orthopnea or PND? What is this???
- certainly has severe left ventricular hyertrophy with strain.
-evidence of a probable old anteroseptal myocardial infarction and suggestion of an inferior wall myocardial infarction
- BP 138/90, HR90 and slightly irregular with probable premature ventricular complaxes.
- S1, S2 is heard. there is no S3, S4 or murmur heard. chest is clear. there is mild peripheral edema. Pedal pulses are poor.
-no carotid brults heard.

I have put names that are foreign to me in italic and in bold - will continue this report as a part 2.
Any and all information would be appreciated, but please explain things in 'lay-mans terms' so these people can understand, Thanks.... now for part two

 

[Duff Man]

this person has heart failure due to or in combination with heart attacks/coronary artery blockages... I think. The peripheral edema is swelling in the ankles/legs/arms that's indicative of heart failure.

 

[Freddie]

Thanks Aaron, so explain heart failure. I don't want to get it wrong. I'm not close to my SO family and I don't have to tell you what would hit the fan if I was wrong in an explanation.

 

[Duff Man]

yikes, kind of a lot of pressure on me Freddie. With all due respect, I don't want to be the guy that alienates you from this person (or said person's family) because I said something wrong or over/under exaggerated. This particular area isn't my strong suit either. I'm not a doctor, standard disclaimer applies.

I can tell you that it's a serious situation this woman is in. It requires prompt attention from specialists. I don't know how old she is, or if she's a candidate for bypass surgery, but it sounds like there's some serious blockages that have already and are continuing to make her heart muscles die and/or function bad, for lack of a better word. The muscle in the heart becomes unusable because at some point oxygen/blood was cut off to that particular area of the heart. It can happen slowly, or suddenly. This is ischemic heart failure.

So basically, from my layman perspective, her heart is not beating efficiently (heart failure) because it's been damaged by the artery blockages that feed her heart muscle's oxygen. This could've happened from a heart attack she didn't notice and lived through, or it could be from a slow process of plaque building up in the arteries that supply oxygen rich blood to her heart muscle.

You really shouldn't quote me on this stuff. If I were you I'd be doing some serious googling in addition to what I told you.

 

[Duff Man]

I'd be remiss if I didn't mention that blood pressure control and monitoring is also important. High blood pressure can cause ventricular hypertrophy that can eventually lead to ischemic heart failure by itself. (ischemic heart failure = inefficient beating heart because of lack of blood supply)

Basically with long standing HBP, the heart works so hard to pump blood against/through the high blood pressure that it gets very big. So big in fact that it can't supply enough blood to all of the parts of the heart muscle, and some of it dies. In this way it becomes a vicious cycle.

The heart pumps very hard because of the blood pressure and then it gets so big it can't pump harder so it dies faster and pumps harder to compensate for the dying parts, and round and round it goes.

 

[Duff Man]

My gut tells me this person's blood pressure and/or heart rate is not under control, and a great first step would be to get that down to a more normal level. I think that the ejection fraction, or in layman's terms the efficiency of the heart in a percentage form, would eventually become higher/better if the blood pressure was better controlled. The heart might become smaller because it can relax and start beating more efficiently just because of that.

Sometimes when people are in heart failure, they're prescribed beta blockers to reduce the size of the heart and thus increase the efficiency because it reduces the hearts work load. That's a tricky call that only a doctor can make. Some people in heart failure should NOT take beta blockers.

 

[zipper2]

Freddie i have heart failure and the way it's explained to me
ismy hearts inabillity to pump sufficent blood to give me a
a normalcirculation. I'm always complaining bout my swollen
legs and need to really watch the ankles closely.In heart failure
i am told that blood backs into my lungs causing congestion
in abdomen or legs,I presently have it very bad and it can ,
well there are alot of reasons for heart failure out there and
i'm not gonna go into detail as im not a Dr.
this is only what ive been told about me,everyones case is different.

I wish you all the best with this and be saying a prayer for you and yours
Take care hopefully someone can help you with all this


zipper2(DEB)

 

[Freddie]

Thanks Deb, I really do appreciate your reply.
Have anything more to add?

 

[KristyW]

- SI][/B]
- extremely poor left ventricular function consideration to full anticoagulation for of thromboembolic events needs to be strongly considered. Target of 2.0 to 3.0
- has some pedal odems? maybe its edema's?
Pedal pulses are poor.

- Thromboembolic events- Blood Clots - Anticoagulation recommended because the blood is not being pumped out of the left ventricle as needed so it can pool and then form clots.

-Pedal Edema - swelling of the feet

-Pedal pulses poor - The pulse in the feet is weak. (The first thing my cardiologist does is make me take of my socks so he can take my pulse in my feet. It is a measurement of how good the circulation is.)

dyspnea? orthopnea or PND, carotid brults, S1 - S4 murmurs - No idea

I think we've answered the systolic qustions and the infarction ones in other posts. Aaron did a great job with the ischemia.

Hopefully somone can come up wth the others. Freddie have you checked WebMD for these terms?

 

[Freddie]

Does anyone object to me printing off the replies so I can show her and that family?
Please, please, PM me and let me know if you would prefer me not to.

Thank-you so very much for your input and information.
Damn you guys are good........give yourself a pat on the back.

 

[notneb1970]

HI,

Dyspenea- shortness of breath
Dyspenea on exertion- shortness of breath with exercise
carotiod- is the main artery going to the brain....they check that for blocks/ stenoisis, because of the risk of strokes.
Bruit is a abnormal sound usually detected when there is a blockage within a vessel.
Pedal pulses can be diminished in patients that have heart failure, MI, DVT's,
diabetes
Hope this helps a little.
Dawn

 

[Freddie]

Thanks Dawn, in this case every little bit does help.