Could my mother's CHF symptoms simply be sporadic or should we call the doctor?

1 answer | Last updated: Nov 13, 2016
Lauries asked...

My mother is 96 and lives out of state with my sister who is primary care giver. Mom was diagnosed some years ago with CHF, congestive heart failure - and has had symptoms which have increasingly become more incapacitating - fatigue, shortness of breath, etc. We have had discussions about end of life and her emphatic "no hospitalization". Yesterday my sister called and my mother was experiencing intermittent chest pains (described as "bursting"), left side, radiating down her left arm (sometimes right arm as well) and ending with a tingling sensation in her fingers and hand numbness. She had five or six of these "episodes" during the day yesterday, lasting less than a minute. My sister administered her nitro pills, but this didn't seem to help. My mother also complained of pain when urinating - although there is output. Today she is feeling better - but still adamant about not going to the doctor. I guess my question is can someone have these symptoms sporadically and at what point do you consult the MD?

Expert Answers

Jennifer Serafin, N.P. is a registered nurse and geriatric nurse practitioner at the Jewish Homes for the Aged in San Francisco.

In your letter, you sound concerned about the chest pains your mother had.  I am sure you are thinking she is having a heart attack!  However, if she is having short bursts of pain, it is more likely to be related to angina, which is a chronic condition.  Angina is chest pain that will go away, and usually helped by nitroglycerin.  This is different than a heart attack, which is terrible chest pain that does not go away on its own. 

I know that you may be concerned about how your family can take care of your mother, especially if she will not go to the hospital.  You may absolutely call her doctor to see if there are any other medications that may help her occasional discomfort, or if you have questions.  Just because someone doesn't go to the hospital doesn't mean we stop trying to help them!  It is just our goals of care are different!

Are you worried about her being in pain?  Or dying?  If these are your concerns, maybe her doctor could refer her to hospice.  Hospice can provide medical care and medications in her own home.  This sounds like something that she would agree with, especially since their goal is comfort and not to hospitalize. 

Good luck!

You may consult a Doctor at any time, but you must realize that your mother's treatment is limited due to the fact that she has a desire to stay at home.