What are the treatment options for multiple heart blockages and 25% ejection fraction?

Hello,

If your father has been diagnosed with multiple coronary artery blockages and his heart function is around 25%, this is a serious condition that needs evaluation by an experienced cardiologist, preferably an interventional cardiologist and, depending on the findings, a cardiac surgeon.

A heart function of 25% generally refers to a reduced left ventricular ejection fraction (LVEF). A normal LVEF is usually around 50–70%. An LVEF of 25% means the heart's pumping ability is significantly reduced. However, 25% does not mean that the heart has stopped working or that treatment is impossible. The outlook depends on the cause, severity of the blockages, heart muscle condition and response to treatment.

Why Can Multiple Blockages Reduce Heart Function?

Coronary arteries supply oxygen-rich blood to the heart muscle. When several arteries become significantly narrowed or blocked, the heart muscle may not receive enough oxygen.

Over time, this can lead to

• Damage to the heart muscle after a heart attack

• Reduced pumping capacity

• Breathlessness and fatigue

• Swelling of the legs or feet

• Reduced ability to perform daily activities

• Heart failure symptoms

If the reduced heart function is mainly caused by poor blood supply, improving blood flow may sometimes improve heart function, depending on how much viable heart muscle remains.

What Treatment Be Required?

The exact treatment cannot be decided from the 25% figure alone. The cardiologist will review the coronary angiography, echocardiogram, ECG, symptoms and other medical conditions.

Treatment include

Medicines

Depending on the patient's condition, doctors prescribe medicines to

• Improve heart function

• Control blood pressure

• Reduce fluid overload

• Reduce the risk of further heart attacks

• Control cholesterol

• Prevent blood clots

• Reduce symptoms such as breathlessness

These medicines should be taken exactly as prescribed. Do not stop heart medicines on your own.

Angioplasty and Stent

If certain blockages are suitable for catheter-based treatment, angioplasty (PCI) be considered. A balloon is used to open the narrowed artery and a stent may be placed to maintain blood flow.

However, with multiple blockages and severely reduced heart function, angioplasty may not always be the best option for every artery.

Bypass Surgery (CABG)

When there are multiple or complex blockages, particularly when several major coronary arteries are affected, the cardiac team consider coronary artery bypass grafting (CABG).

During bypass surgery, blood vessels from another part of the body are used to create new routes around the blocked coronary arteries.

Whether bypass surgery is appropriate depends on the location and severity of blockages, heart function, overall health, kidney function, diabetes and surgical risk.

Additional Heart-Failure Treatment

If the 25% heart function represents heart failure with reduced ejection fraction, the cardiologist may also consider specific heart-failure medicines and, in selected patients, devices such as an ICD or CRT.

These decisions depend on the patient's ECG, rhythm, symptoms, duration of reduced EF and response to medicines.

What Tests Should Be Reviewed?

Before deciding between medicines, angioplasty or bypass surgery, the cardiologist review

• Coronary angiography

• 2D echocardiography with LVEF

• ECG

• Troponin, when relevant

• Kidney and liver function

• Blood sugar and HbA1c

• Cholesterol profile

• Blood pressure

• Previous heart-attack history

• Current medications

In some patients, additional testing may be required to determine whether weakened heart muscle is still viable and could benefit from restoring blood flow.

Is Heart Function of 25% Dangerous?

It is significantly reduced and requires proper medical management, but the number alone does not determine the patient's outcome.

Some patients with an EF around 25% improve considerably after appropriate treatment, especially when the underlying cause is identified and treated. The doctor will monitor the EF over time rather than judging the condition from a single echocardiogram.

When Should You Go to Emergency?

Do not wait for a routine appointment if your father develops

• New or severe chest pain

• Severe or rapidly worsening breathlessness

• Breathlessness while resting

• Fainting or severe dizziness

• Sudden sweating with chest discomfort

• New confusion or extreme weakness

• Bluish lips or severe difficulty breathing

• Rapidly increasing swelling with breathing difficulty

These symptoms can indicate an acute cardiac problem and require immediate hospital assessment.

What Should Your Family Do Now?

Because your father has multiple blockages and an EF of approximately 25%, arrange a consultation with an experienced cardiology team rather than deciding independently that he needs either angioplasty or bypass surgery.

If you already have his angiography and echocardiography reports, take them to the cardiologist. The specialist can determine whether the blockages are suitable for angioplasty, whether bypass surgery would provide better benefit, or whether intensive medical treatment is appropriate.

How HexaHealth Can Assist You

We work with several partner hospitals and experienced cardiologists and cardiac surgeons.

We can assist you with

• Finding a suitable partner hospital for complex cardiac care

• Connecting your father with an experienced cardiologist/interventional cardiologist

• Coordinating a second opinion on angiography and echocardiography reports

• Understanding whether angioplasty or bypass surgery may be considered

• Coordinating consultations, investigations and hospital admission

• Helping with treatment coordination at our partner hospitals

Please share your father's city and state. We can help connect you with an experienced cardiac specialist at our partner hospitals.

Wishing you and your family good health always.
Warm regards,
Team HexaHealth