### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
My 61 year old husband was diagnosed with hypetrophic cardiomyopathy a few years ago. He has been seeing a Cardiologist ever since and a pacemaker/difibrilator was placed to reduce his risk of sudden death. In March his legs started swelling and he was very short of breath and was taken to the ER where he was diagnosed with CHF. He was hospitalized for one day while the fluid was removed and was sent home with strict diet instructions. He s on several medicines to which they ve now added a low dose diuretic. He s done very well sticking with the low sodium diet, exercising, and following all of the lifestyle chances. He has maintained his weight and feels better than he has in a year or more. I m very confused as to his prognosis. When I asked his cardiologist about a prognosis I was told that he has the good kind of heart failure and that the main issue to worry about is sudden death which is why the device was implanted, but when I talk to our family doctor he doesn t seem to think he ll live very long. The ER cardiologist mentioned that he didn t think the ChatDoctor was being managed well enough and changed several dosages of his medicines. He also mentioned that there are two surgeries that are options if his condition worsens. One is an alcohol ablation and the other is septal myectomy. My question is two-fold: Realistically does he fall into the dreaded 50% chance of dying in 5 years, or since the heart failure seems to be caused by the ChatDoctor can either of these two surgeries turn the heart failure around? What is the good kind of heart failure? I ve never heard of such a thing. I m younger than he is and we have a young child together the stress of constantly worrying about his life expectancy is overwhelming.

### output:

Hi, Lets start from the surgery. Your doctor may have explained to you that in hypertrophic cardiomyopathy the heart muscle gets very thickened. Such thickened muscle may produce life-threatening arrhythmias, that's why defibrillator was implanted, which is the most efficient way to prolong the life of patients with hypertrophic cardiomyopathy. Also, in some cases, the thickened muscle obstructs a part of the heart from where blood flows from the heart to the aorta. Two types of surgeries, who mentioned are done in this case. They are meant to reduce the thickness of the muscle in the heart septum, thus, give a chance to blood flow to the aorta. Heart failure in patients with hypertrophic cardiomyopathy have two causes 1. The obstruction I have mentioned above 2. When heart thickened heart muscle starts work weak, and heart can't pump enough blood to the body. You can talk to your doctor to find out which one is the case of your husband. In the first case, the surgery may help. In the second case, only medications are indicated. The life expectancy of heart failure patients depends on many factors, one of them is how weak is heart muscle. But usually if you can achieve good results with medications, his 5-year life expectancy may be quite high, especially if he has a defibrillator. Hope I have answered your query. Let me know if I can assist you further.  