Heart failure due to lung congestion? Bit Confused.

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CAlbert
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Date Joined Sep 2017
Total Posts : 3
   Posted 9/19/2017 8:58 AM (GMT -7)   
My mom, aged 78, underwent angioplasty/stent for MI around 5 years back. However, after the heart attack she was perfectly fine, and active, other than getting frequent lung congestion.

At the time of of MI, her EFR was 40%. However, 5 months back her LVEF/Ejection fraction increased to 46%, and all the other reports appeared perfectly normal. Can 46% EFR cause lung congestion?

Recently she went to another city, where she developed severe wheezing, phlegm, and COPD (Chronic Obstructive Pulmonary Disease). At the time of admission to hospital again, her CPK was 700, but Troponin was normal. The CO2 in blood was 80%, and the doctors were telling she was not getting enough oxygen from lungs. In critical care, the CO2 level was brought down to 40%, and one day after we shifted her to a normal room from critical, unfortunately my mom passed away due to another MI.

I'm bit confused, trying to understand - whether not enough oxygen from lung had damaged the heart, or other way where the heart was not pumping enough blood to lungs? I thought 46% EFR is okay for old aged people. What could be the reason for this second massive MI?

Can any expert/experience member(s) in this forum can comment on this?

Thanks.

straydog
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Date Joined Feb 2003
Total Posts : 15696
   Posted 9/19/2017 12:06 PM (GMT -7)   
I am very sorry to read about your mom, you have my deepest condolences. If I am reading this right her oxygen levels decreased & her heart was not getting enough to properly pump the fluid off of her heart. Therefore, congestive heart failure entered the picture & MI.

None of us are drs here nor are we experts. I have heart issues along with a sibling of mine that has since passed. He had problems for years with CHF & COPD. The two worked against him & his heart finally just gave out. In his case his heart could not pump off the excess fluid & the diuretics could not either.

Again, I am so sorry about your mom.
Susie
Moderator in Chronic Pain & Psoriasis Forums

theHTreturns...
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Date Joined Mar 2009
Total Posts : 20097
   Posted 9/19/2017 6:07 PM (GMT -7)   
my deepest of condolences. i think along the same lines as susie.

CAlbert
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Date Joined Sep 2017
Total Posts : 3
   Posted 9/22/2017 7:14 AM (GMT -7)   
Thanks Susie. I happened to see the discharge summary now for my mom after she passed away. It says my mom was admitted with respiratory failure type 2. My mom had a very long history of bronchitis and wheezing for several years, before getting the first MI. I really doubt whether a consistent ejection fraction of 46% can cause this much damage to the lungs, not able to expel out CO2. Do you think EFR of 46% would be sufficient to manage the lungs? My mom did not have any fluid retention anywhere in the body, especially no swelling in feet etc during physical examination done by the cardiologist.

Thinking COPD is the culprit this time, causing more damage the heart muscles for a stable heart with one MI before. Never know heart and lungs are so much intertwined.

theHTreturns...
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Date Joined Mar 2009
Total Posts : 20097
   Posted 9/22/2017 8:35 PM (GMT -7)   
certainly are. kidneys as well. as i found out with acute renal failure post double by pass caused by a inotropic heart failure!! keep strong.

straydog
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Date Joined Feb 2003
Total Posts : 15696
   Posted 9/24/2017 6:33 PM (GMT -7)   
I would look to see what is listed on the death certificate.
Susie
Moderator in Chronic Pain & Psoriasis Forums

CAlbert
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Date Joined Sep 2017
Total Posts : 3
   Posted 9/26/2017 5:27 AM (GMT -7)   
This is what I see in the in-patient death summary.
Patient was admitted in the ER with a history of shortness of breath for couple of weeks which worsened in the last few days, cough with expectoration and mild fever. Blood and urine cultures are normal and sterile.
Arterial Blood Gas at the time of admission showed type II respiratory failure (with CO2 -80%), and X-Rays suggested COPD. Echo showed septum, LV dysfunction, LV EF 30%, type II LV diastolic dysfunction. When she was shifted to a private room, she appeared very normal. However, on the very next day morning she was found unresponsive with cardiac arrest. CPR given, with vasopressors/ventilator support she survived for a day, and then finally her blood pressure completely crashed and she passed away.

Post Edited (CAlbert) : 9/26/2017 6:30:21 AM (GMT-6)


straydog
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Date Joined Feb 2003
Total Posts : 15696
   Posted 9/26/2017 7:02 AM (GMT -7)   
My thoughts are that some time in the night her oxygen level bottomed out & hence the heart attack. Given her age & prior history & COPD, it takes a toll on a person. I don't know if she was under regular care with a pulmonary dr or not. When she was first dx'd with COPD, she should have been seen periodically to monitor this. Even people with mild COPD seek care with a pulmonary dr. You cannot cure it, but progression can be slowed down with treatment.

The last three years of my brother's life COPD was a huge problem that required hospitalization. They would always bring in the top pulmonary therapist to work on him to get his oxygen levels up. Just putting him on oxygen was not enough. I watched them work & work with him & it would take a couple of days to get him stable.

I do hope that you can get some closure. I have lost both of my parents & truly understand where you are at. Take care.
Susie
Moderator in Chronic Pain & Psoriasis Forums
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