Conversation: The conversation between human and AI assistant.
[|Human|] My father, 81 had bypass about 9 years ago. He is now having regular angina. He had dye injected and the main bypass still looked good but some of the smaller ones have blockage. His cardiologist didn t recommend any surgery at this point - just changed his meds. Advised is a candidact for heart attack but that where blockage is would be too risky to operate. Dad has pains several times weekly and also has several times had to use three nitro pills to resolve. He has an EF of about 40 and possibly may do a pacemaker at some point. Seems we are at wait and see. Still leads a busy life style. Working and getting around Ok but having a lot of pain fairly often. What type of life expectancy could he have if nothing changes. Non-smoker, reasonable diet, 160 lbs but limited energy at this point.
[|AI|]  Hi pacemaker is required for critically lowered ejection fraction less than 30%, your father is 40% which is not that bad. If your cardiac surgeon is saying that CABG can cause more harm than benefit, then you can ask him to keep your father on chronic antianginal, they are highly efficient in reducing stable anginaApart from nitrates he can take tablet reinflating, trimetazidine and nikorandin in therapeutic doses. In fact trimetazidines apart from being a chronic antianginal will also improve his cardiac functions