Cardio Notes

I asked a cardiologist that I know if there was a gentle way to ask my mother's cardiologist if they're doing all they can. My suspicion is that they could do more, but given her age and relatively frail condition, are unwilling to push it. She told me some interesting phrases and numbers to look for. Some I'd known, and some I hadn't.

One is 'ejection fraction'. This is the percent of the blood in a ventricle that gets pumped when the heart beats (aka 'systolic pressure', the first of the two that make up blood pressure readings; the second number is 'diastolic pressure'). A normal reading is about half to two thirds; anything less than half can suggest that the heart isn't pumping enough blood to satisfy the needs of other organs (ie, brain, kidneys). Less blood being pumped means less blood to oxygenate, which is not good. It also means blood is pooling instead of flowing, which leads to edema (puffiness). Another, which I had not known, is 'diastolic function', which is the ability of the left ventricle to fill and then discharge its load of blood. If it can't do that easily, you essentially get a plumbing problem - you generate a back pressure wave down to where the oxygen transfer is supposed to be happening. She puts it very clearly here:

When there is higher pressure in the tiny hair-like blood vessels that go past the air sacs in the lung (and accept the oxygen from the lungs to oxygenate the blood), the higher pressure causes water to leak OUT of the blood vessel and INTO the air sac. Well, if you have water in the air sac, it is difficult to move oxygen past the water, so you don’t oxygenate the blood as well. That is water in the lungs. Patients get short of breath when this occurs.

That condition is known as pulmonary congestion.

Since my mother's problem is shortness of breath, both of these sound interesting. Question is, how to bring it up to the doc without getting into a game of buzzword bingo.