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Question asked by Aishah
My 74 year old grandmother was recently diagnosed with heart failure. Doctors claim she has just 29% of her heart’s life left. She is diabetic and has high blood pressure as well. She recently became very ill when fluids filled up in her lungs leading to breathing issues and an increased heart rate. While in the hospital she had to receive cardioversions twice to reduce her heart rate. Kindly advise me on what precautionary measures we can take and what we can expect for her future health.
Answered by Dr. Brian Jaski

Several important points emerged from your question. First, I would define ejection fraction as the amount of blood ejected by the heart with each beat as a fraction of what it starts with at the beginning of a beat. For example, if the heart has a 100ml of blood at the beginning and ejects 60ml leaving 40ml, that would be an ejection fraction of 60%. If the heart were to flatten like a pancake when it contracted, the ejection fraction would then be 100%, but that never happens. Normally the heart ejects about 2/3 of the blood it starts with at the beginning of a beat. So if your grandmother has an ejection fraction of 29%–that is seriously decreased but it’s not 29% of 100%, but 29% of a normal range of 55-75%.

Secondly, your mother was given a diagnosis of “Heart Failure”, I like to use the analogy of a car–this would be like a mechanic saying you have “engine trouble”. The question is why? For example is there a problem with her heart arteries (“fuel lines”)? Is her heart muscle weak despite an adequate blood supply (“bad cylinders”)? Does she have a problem with the electrical activation of her heart (” a problem with the distributor”). The answer to these questions may lead to specific therapies that could help her.

Lastly, In general, there are recommendations that should come from her doctor and medical team, including medication, diet and exercise. Please look at the sections in our website specific to these topics which may help.

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