Hello,
Thank you for your query at DoctorSpring.com
Your father is presently suffering from dilated cardiomyopathy with left ventricular failure and severe mitral regurgitation. Also there is a pleural effusion which could be due to heart failure or tuberculosis as per investigations. Did your father have this diagnosis of dilated cardiomyopathy for a while now or is it a recent diagnosis. If it us a long standing process of poor heart function then a AICD would be indicated for primary prevention of sudden death. If all the problems have begun recently then it would be appropriate to wait for few months before taking a decision on AICD. The heart function may improve spontaneously in case of certain infection in body. But if ot doesnt go beyond 35 percent after aay 6 months then AICD is indicated. As far as pacemaker is concerned it is for slow heart rates. Does he have slow heart rate? Please upload ecg. Given that he is on tuberculosis treatment it would be better to wait for 6 months before any pacemaker or Aicd if not urgently indicated fir low heart rate. Also a coronary angiography to look for cause of heart failure would be appropriate and can be done right away.
Regards
Dr Vivek Mahajan
DM Cardiology
Patient replied :
Dear Doctor,
Thank a ton for your reply.
Please note that the issue mentioned to you is a current issue. The last ECG report shows 'Left bundle branch block'.
Kindly advice.
Regards,
Rajat
Hello,
If the issue is a new one and not a lpng standing one you should wait for spontaneous improvement in lv function over next few months. If the ecg shows lbbb and the function doesn't improve he should undergo a coronary angiography and if no significant blockages he may be a candidate for CRT-D which is not exactly a pacemaker but somewhat similar. Still you should wait for sone time for tb treatment to be completed and heart function may show spontaneous improvement.
Regards
Dr Vivek Mahajan
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