Myocardial infarction and prognosis

[Never give in]

My husband was 28-years-old when he suffered a serious heart attack.  He had a 90-95% blockage in his LAD.  Due to his young age, he was misdiagnosed at a small, rural hospital, and was nearly dead when we reached an adequate medical facility.  Originally, it was thought that the blockage could not be cleared as the blood flow would be completely compromised, and he would suffer a fatal stroke during the procedure.  Several days later, we were transferred to a large hospital and placed on a transplant floor.  Miraculously, the blockage was cleared by a very gutsy doctor, and my husband survived.  Now, he has an EF of 25ish with significant damage to his LV.  He has problems with SOB and fatigue that seem to be worsening.  Today, he had a CPX stress test run and his VO2 max was measured at 22.  Last year, his VO2 max was 24, but his EF has remained consistent.  Does anyone have any input on how close he might be to needing a heart transplant?  Considering his young age (now 33), do you think he will ultimately need to be transplanted?

[mmfd]

It is impossible to say.  If he takes the correct drugs correctly, watches his sodium intake religiously, weighs daily, exercises (of course with his doctor's permission), and has a positive attitude, a lot can go right.  Some can live for years with low ef's and still work full time.  I would strongly suggest  going to chfpatients.com and reading all you can.  Aggressive treatment can really pay off.  I had an EF of 15% in June, 2002 and was told I would probably need a transplant, and here I am with an ef of 50% doing well!  I didn't have a heart attack, though, as I have familial dilated cardiomyopathy.  I think it is important to have a cardiologist that will treat aggressively and really knows his CHF.  Good luck.

[anacyde]

never give in: I'm sorry to hear about all your husband has gone through, that is a terrible thing so young.  Like mmfd said, careful watching can lead to a positive outcome.  25% usually doesn't land people on the transplant list, but anything under 30% is usually cause for an ICD if there is no improvement.  Since your husband's reduced EF is from heart damage and not a cardiomyopathy, I have no idea what the stats are on improvement, but I do know that people can live a very long time with a reduced EF.  His symptoms would be the biggest concern, from a quality of life standpoint.  Cardiac rehab is often very helpful in situations like his, to regain stamina (though there is usually little effect on actual EF).

I sincerely hope he improves.

[anacyde]

I've seen you post before, and I had no idea you'd been diagnosed with such a serious DCM.  Your recovery is awesome, I'm glad you're doing so well.