Got an update from Dr. Jane Moses:

"In terms of the results of the tests done so far - the cardiac MRI showed that at some point he had a heart attack. Our current thought is that he initially had a viral infection of the heart in 2019 when there was also clot noted in the left ventricle. This clot must have broken off and caused a heart attack at a later point, accounting for the decline in heart function seen between 2019 and now. The coronary angiogram and left and right heart catheterisation showed that the blood vessels supplying the heart are normal and that the high pressure in Riaan’s lungs that was noted on the echocardiogram is only as a result of the heart and not from additional lung pathology. The transoesophageal echocardiogram (TOE) showed that there is clot present in the left atrium as a result of the rhythm (atrial fibrillation) that his heart is in at present.

In terms of the way forward:

1. We still need to further optimise Riaan’s medications - this can hopefully be done as an outpatient with frequent follow up in our outpatient clinic.

2. We still need to address the atrial fibrillation by way of shocking his heart back into rhythm, but the clot that is there will need to dissolve first, so this will only be in about 6 weeks time."