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He had been diagnosed with bronchitis about 3 weeks ago and wasn't getting any better so we took him back up to the hospital to find out he had a heart attack, Friday before last he had a 50/50 chance to live and he pulled through the 24 hour watch, and he was discharged this past Thursday. Saturday he was having shortness of breath and was turning a bluish grey so we called the ambulance and he's back in the hospital for now.. will he ever improve?

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No sorry. They may recommend hospice soon .
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So sorry to her about your brother but as was said above we do not know the whole story. It is clearly a very serious situation and may not be survivable so of course you need to prepare for that eventuality but these days medical miracles can be performed and he may even be considered for a heart transplant and live many years after that. Don't give up hope. Blessings
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My mom has CHF since age 58, now 72 but fading fast. With proper medical care hopefully your brother still has many years ahead of him! Don't despair...
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One interesting thing about a low ejection fraction is that the heart wants to survive. That's it's sole purpose--to keep pumping. With a low ejection fraction the heart does something amazing. It creates little vessels called collaterals out of its own tissue for the blood to circulate. These collaterals bypass the damaged vessels and are able to carry blood throughout the heart.

Collaterals can buy the person some time. They're not a permanent fix and they don't cure anything but your brother's sweet heart is working very hard to survive.
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No one here can tell you that because we don't know what the underlying causes are, we don't know anything else about complicating factors, medical history, what the proposed medical treatment by a cardiologist is, etc.

This is a question you need to be asking his cardiologist.

I'm wondering if he has a congenital heart defect, if he's in poor health, and if there are other factors. There could be many issues involved.

If you mean that his ejection fraction is 15%, that's very, very low. Normal is generally 55% - 70%, although someone can live with a much lower EF, including with a pacemaker if it's indicated. Whether your brother could benefit from a pacer is something that should also be asked of the cardiologist.

http://my.clevelandclinic.org/services/heart/disorders/heart-failure-what-is/ejectionfraction - is a good article on EF and although technical, it can help you understand the underlying issues.

CHF can be cured; my father has had it multiple times, but he has A-Fib. He also has an EF in the high 20's and has had it at that level for a few years. But he's also as active as he can be at his age and doesn't accept defeat.

I would (a) ask one of the nurses to tell you what your brother's specific cardiac condition is, and any other issues she can share with you. Then either try to be there when the doctors make their rounds, call their office, or write a list of questions for one of the nurses to give to the doctors and ask that one of them call you back.

Your brother is very young to have had a heart attack; there may be some health issues, family history, or something else taking place but the only way you'll find out is from the medical staff.

I hope this helps; this must be very frightening and sad to have a brother undergo such a devastating event so early in his life.
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