instruction: hi doctor my father has acute heart failure and extensive mi since two months ago also he got a pleural effusion and leg edema he is in bed symptomatic depending on oxygen device most of the time his ef is 21 the egg shows possible left atrial enlargement nonspecific intraventricular block right ventricular hypertrophy inferior infact and anterolateral infact irs 138 with right bundle branch block he sleeps in a 30 45 degree we did not do pi until now I would like to know will crud be good for him
output: hi as he had a heart attack first priority is revascularization of angioplasty or bypass surgery if this is done and heart function improves then it will be good in right bundle branch block there is very little benefit of cut cardiac resynchronization therapy if revascularization is not possible then maximum medical therapy is best yes ice implantable cadioverter defibrillator is indicated it should be considered once the patient is out of the acute episode and is stabilized if the patient needs recurrent hospitalization for heart failure or recurrent be drops that need medicines to raise it then the option is left ventricular assist device lvad or total artificial heart tah or heart transplantation subject to availability of facilities first thing is to assess for revascularization if there is viable heart muscle I hope this helps