Q: My father is 67 years old and has had a bypass surgery when he was 60. He is a diabetic and has been taking medicines regularly. Recently my father began complaining of chest pain and breathlessness (he can differentiate between chest and cardiac pain) it was more a feeling like the food that he was eating was getting stuck in his chest and was not getting digested. We went to the hospital to consult a doctor and he was put on saline and given external oxygen (because he was complaining of breathing difficulties) and in two hours he was fine and we got back home. But he never recovered and finally 5 days ago he was admitted to the hospital because he was finding it very difficult to breathe and at the hospital we were told that he would need to be admitted. The doctor who was taking care of him told me that when he was bought to the hospital his condition was not so bad but as time went by he got worse and he told me that in clinical terms it is known as heart failure. Consequently he was given anaesthesia and was being fed through his nose and a pipe was put through his mouth internally (I was told that it was external oxygen being given to reduce the load on his heart) and he was unconscious for 36 hours. When asked for the reason as to how my dad was finding it difficult to breathe the nurse told me that it was due to congestion in the lungs. Now my father is doing slightly fine, he is still in the hospital though and he breathes through external oxygen given through his nose. He is totally consious now but if he removes the oxygen pipe then after about 5 to 6 hours he finds it difficult to breathe again. His BP reading is 96/68 and his heart rate fluctuates between 76 to 104 and his blood sugar is 15. What I would like to know is what is the problem with my dad and in what way can it be cured?

A:It appears from the details that your father has had a coronary event (myocardial infarction or unstable angina) due to blockade of a graft or native vessel. This has probably resulted in weakening of heart muscle leading to severe left ventricular failure. He may need a coronary angiography to decide regarding the further management depending upon the angiographic picture the extent of residual angina and the left ventricular function. The symptoms before the admission was clearly angina. I think he needs very energetic treatment.