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

### input:
Hello, I am now 54 and had a stroke at 53 in April this year and heart failure. My heart is now only functioning at 10-15% capacity. I have been assessed for heart replacement but have been told that is not necessary at this stage. Will my symptoms gradually worsen and if so over how long a period. I am now on medication for life. My medication is ramipril, sprionolactone, bisopropol, simvastatin, warfarin and digioxin. Would appreciate any thoughts you may have. Thank you. Mark

### output:

Hello. Thank you for asking on Chat Doctor. I understand your concern. Now, the therapy you described you are taking, is crucial in stopping the progression of congestive heart failure and further remodeling of heart chambers. A normal heart pumps 55-70% of its content during one systole. A damaged heart, whatever is the cause, that is pumping 10-15% of its content, means that contains 85-90% of the content after its contraction. This is accompanied with high pressures throughout the body. Any factor that "helps" in raising this pressure, can decompensate your condition and put you in dangerous symptoms, such as salt intake, moderate to vigorous physical activity. Another thing is that a dilated cardiomyopathy (enlarged heart) is prone to dangerous, potentially life-threatening, arrhythmias. At this stage, no matter the life expectancy, I would recommend you to discuss with your regular physician/cardiologist about the possibility of implanting an implantable cardioverter-defibrillator (ICD) to prevent these arrhythmias. I hope I was helpful. Take care.