What is the prognosis of my hospitalized father suffering from heart failure and impaired kidney?

Hi,

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Sorry to hear about your father's health. Seems like he is in cardiogenic shock with multi-organ dysfunction. The present prognosis is not good, but if he has some actual issues on the background of previous heart failures like acute heart attack, severe infection, drug overdose, etc., in that case treating the inciting issue will make the prognosis better. As he is on inotropic support, hope this will maintain his blood pressure. If not, dual support can be started. In the case of cardiogenic shock, mechanical circulatory support can also be started if available on a temporary or permanent basis. Kindly share his echocardiography report and angiography if done, and other reports like complete blood count, chest X-ray, etc., and tell how is his urine output in six hours and 24 hours. So that I can guide you accordingly. I hope I clarified your doubts. Thanks and regards.

Hi,

Welcome back to icliniq.com.

These are renal and liver function tests which are deranged as you told me (attachments removed to protect the patient’s identity). Multi-organ dysfunction does make the prognosis worse. Kindly share his electrocardiogram (ECG), angiography, and chest X-ray. Take care of your father. Thanks and regards.

Hi,

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Sad to know about his condition. If his left ventricle is weak and blood pressure is low and an acute cause is to be treated, then the blood pressure is supported with IV (intravenous injection) normal saline infusion if no fluid is overloaded. If it does not raise blood pressure or fluid overload is there then IV (intravenous injection) medicines can be started to raise the blood pressure. One of them is an IV injection of Norepinephrine (a combination of catecholamine and Phenethylamine) and the other is Dobutamine (beta blockers). Take the medications after consulting your specialist doctor.Some patients recover from life-threatening situations and then regular heart failure medicines can be started. Take care of your father. Thanks and regards.

Hi,

Welcome back to icliniq.com.

When the left ventricle fails, fluid accumulates in the lungs which is known as pulmonary edema (swelling). When the right ventricle fails, fluid accumulates in the body. In the case of biventricular failure fluid accumulates in both the right and left ventricles. If no adequate urine output with Furosemide, then the combination of Furosemide (lactose monohydrate NF, magnesium stearate NF, starch NF, talc USP, and colloidal silicon dioxide NF) and Metolazone (Quinazoline) is given, If these medications are not helping then ultrafiltration is done with a dialysis machine in which fluid is removed with the help of a dialysis machine. I hope I clarified your doubts. Thanks and regards.