Heart attack, emergent quadruple bypass

Dr T Ask Doctor T, Cardiac Risks Leave a Comment

Question

Thank you for taking my question.  My father in law is 76.  Last Friday after experiencing chest discomfort he was brought to ER and immediately to the Cath lab.  The dr who did the Cath said he would have not survived the day had he not come in.  His EF was between 10% and 15%.  He needed emergent bypass that day.  He came out after having a quadruple bypass.  Tomorrow will be a week.  He is retaining fluids despite aggressive diuretic treatment.  His echo as of yesterday has shown no improvement in heart EF.  Still 10-15.

He has lived VERY healthy.  Just had a physical with EKG 2 wks ago. Passed with flying colors.  Never hbp Normal cholesterol, regular exercise, vitamens and a good diet with low weight, never smoked.  Nothing.

So my questions are…
Can we expect his EF to improve?
Should he see a cardiologist that specializes in heart failure?
What are we looking at for him long term?
My Mother in law is anxious to get him home.
Thanks so much for your time!!!!
Chris

Answer
Hi Chris,
Improved heart function (as demonstrated with the Ejection Fraction) happens often if there was “viable but ischemic” heart muscle before the operation:
If the coronary artery bypass surgery (CABG) is proven  successful, not only for the grafts to work but in recruiting heart muscle that received insufficient blood supply before the operation (it is called “dormant”). It is one of the great benefits of bypass surgery, as opposed to stents.
I have included some articles I wrote previously on the subject:
Hope this helps,
Dr T

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