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Ask Dr.S.A.Alam Your Own Question
Dr.S.A.Alam
Dr.S.A.Alam, Doctor
Category: Health
Satisfied Customers: 4425
Experience:  MBBS/FCPS(Internal medicine/cardiology) MRCP(R) U.K
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my mother recently had a heart attack about 2 months ago and

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my mother recently had a heart attack about 2 months ago and we brought her home
she is very weak and has low blood pressure all the time,she has developed a kidney
infection and is passing some urine a little, she is on an antibiotic but not eating and
on alot of medeication, has a patch for pains in legs at nite,which have improved,we have
help with the palative care team which are great help,she is now totally exhausted,sleeping
all the time,could her damaged heart with the low blood pressure cause her kidneys to
not function properly,she is 84 years old, would appreciate your help,she seems to be
deteriating before us, and not eating weaker and weaker,thanks

Dr.S.A.Alam :

Hello, Thank you for your question,

Dr.S.A.Alam :

Q... What was the ejection fraction of the heart on echocardiogram test ?

Customer:

she has a scar in her heart not able for angeogram as too weak and her age is against her

Dr.S.A.Alam :

no, not angiogram

Dr.S.A.Alam :

i said echocardiogram

Dr.S.A.Alam :

or ultrasound of the heart.. ?

Dr.S.A.Alam :

Did they mentioned strength of the heart ? it is low or normal ?

Customer:

all i know is that she had a massive heart attack and the heart doctor said her

Dr.S.A.Alam :

Ok, i will try to explain what might have happened and what needs to be done to correct this

Dr.S.A.Alam :

In heart attack the heart muscles get scarred and loose their strength to function normally.

Dr.S.A.Alam :

we call it in medical terms ejection fraction or

Dr.S.A.Alam :

strength of the heart

Customer:

life had been shortened, she has low blood pressure all the time

Dr.S.A.Alam :

As her blood pressure is low so this is very much possible that heart muscles are severely damaged

Dr.S.A.Alam :

and this has caused low blood pressure.

Dr.S.A.Alam :

This low blood pressure leads to what we call as cardiorenal syndrome.

Dr.S.A.Alam :

in which there is poor blood flow to the kidneys

Dr.S.A.Alam :

and this presents after massive heart attacks

Dr.S.A.Alam :

This seems to be likely in her case.

Dr.S.A.Alam :

So now what are the options.

Dr.S.A.Alam :

First she needs an echocardiogram to see if this kidney function is low because of poor heart function.

Dr.S.A.Alam :

The doctor will tell you ejection fraction or EF is low.. or not...

Dr.S.A.Alam :

then we can lower the heart medicine if she is taking for her heart attack

Dr.S.A.Alam :

like ACEi, beta blockers and diuretic group of medicine.

Dr.S.A.Alam :

these need to be lowered if the blood pressure is low....

Dr.S.A.Alam :

If this does not help then we have to add short term ionotropic support to help her.

Dr.S.A.Alam :

If the echocardiogram shows that her heart is weak then kidneys are effected most likely due to poor blood flow. Then best option left for her is to go for ventricular assist devices.

Dr.S.A.Alam :

You have questions ?

Customer:

but she dosnt want to go to hospital agin and she is too weak for tests,so do you think she can recover

Customer:

what is ventricular assist devices

Dr.S.A.Alam :

Well, it is not possible to estimate the recovery if we do not have full heart data

Dr.S.A.Alam :

and most important is echocardiogram.... On the basis of this test we can tell the possible outcome.

Dr.S.A.Alam :

These are devices which act as pump

Dr.S.A.Alam :

and take over the heart function for few months... this helps heart muscles to get time for recovery.

Dr.S.A.Alam :

These devices are always placed in patients who have very poor heart function and cannot undergo any other treatment.

Dr.S.A.Alam :

You have questions?

Dr.S.A.Alam :

Queries ?

Dr.S.A.Alam :

You have questions ? should i wait for more questions ? let me know......

Dr.S.A.Alam :

It was nice to have chat with you.

Customer:

unfortunnately my mother is at home and cant used devices so i guess she well get weaker the doctors gave

Customer:

us no time but i guess we know the outcome not much time left, thanks for been so helpful these time

Customer:

are difficult for her and my family, siobhan

Dr.S.A.Alam :

You are welcome.

Dr.S.A.Alam :

It was nice to have chat with you.

Dr.S.A.Alam :

Do rate the answer as excellent if i have answered your questions. Thank you.

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