treatment options for low ejection fraction 35 or under and no symptom

Posted by seth250 @seth250, Dec 1, 2016

my ejection fraction seems to have been misread by echo, revaluate by stress nuclear at 35, then mir at 20 and then after hospitalization 35 by echo
what are the right treatments opyions- drugs or implant
no real information from cardiologists but some non ischemic heart beats

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Welcome to Connect, Seth.
I'm tagging a few other Connect members who have also experienced reduced ejection fraction in the hopes that they can offer some thoughts. @thankful @bibi12 @murryone @cynaburst any input for Seth?

Seth, what treatment options are being suggested by your cardiologist?

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Have they given you a diagnosis? Possibly dilated cardiomyopathy? The treatments for systolic heart failure, which is what you are dealing with are either medications. Some possibilities are things like beta blockers, diuretics, ARBs, ACE inhbitors. Another possibility is a bi-ventricular pacemaker or defibrillator. It sounds like you need to find out what is causing your systolic heart failure. Are you also having arrhythmias? That is another issue that can be addressed various ways. It seems like you need a bit more clarity on your condition. If your current doctor is not providing this, maybe you should get a second opinion.

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@cynaburst

Have they given you a diagnosis? Possibly dilated cardiomyopathy? The treatments for systolic heart failure, which is what you are dealing with are either medications. Some possibilities are things like beta blockers, diuretics, ARBs, ACE inhbitors. Another possibility is a bi-ventricular pacemaker or defibrillator. It sounds like you need to find out what is causing your systolic heart failure. Are you also having arrhythmias? That is another issue that can be addressed various ways. It seems like you need a bit more clarity on your condition. If your current doctor is not providing this, maybe you should get a second opinion.

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Thank you, I have not gotten a clear opinion from Dr as to why latest Echo showed 35 and strong heart when in hospital for drug interaction There is some arthmyia but dont know what is standard Looking for a second opinion in early January Thanks Good to speak to someone who understands this

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@colleenyoung

Welcome to Connect, Seth.
I'm tagging a few other Connect members who have also experienced reduced ejection fraction in the hopes that they can offer some thoughts. @thankful @bibi12 @murryone @cynaburst any input for Seth?

Seth, what treatment options are being suggested by your cardiologist?

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At moment concept is try drugs and maybe trial of new drug and then probably defribulator
Dr doesn't give much feedback
Trying to get a few more opinions
No blood vessel problems

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@seth250 - I had the "widow maker" HA back in May of 14 and as a result have a EF of 35. I take 2.5 mg. of Lisinopril, 50 mg. of Metoprolol Succinate, and 40 mg. of Simvastatin each day as far as pharmaceuticals and a number of supplements that I have done research on that I feel make a big difference on how I feel. I work out 3x a week for about 1 1/2 hrs. and am winding down my remodeling business just taking on smaller jobs from past clients these days.
In my case the Echo was the test that finally got the attention of the cardiologist when I went to the ER that day. After several typical tests (EKG, X-Rays, etc.) once they settled me down with some pain meds they had planned to admit me and have me take a stress test the next morning. My wife left the hospital to pick up my PJ's and toiletry bag and soon after the Echo Tech came in and began his testing. About half way through the test he left the room and moments later the cardiologist returned with him and things moved in high gear from that point on! My wife barely made it back by the time they were rolling me in to the lab.
I received a single stent in my LAD for 100% blockage and unfortunately the lack of blood flow to my left ventricle did some serious damage.
But, praise God I am alive! Since then I have had 2 other Echo's and there has been no real improvement in my EF.
They did do a drug induced stress test about a year ago with nuclear and MIR and I sat in with my cardiologist to view the pictures taken of both before and after and there was barely a pixel change so therefore they felt there was no concerns at that point.
I feel for me I need to do my part now in doing my best to live as healthy as I can. That is why I try to eat well and less to get to my weight goal of 165
lbs. (I'm 5'10") and I have another 10 lbs. to go. Continue to exercise and eliminate more stress in my life. Living in a small town in OR helps with that!
All my best to you and I hope you and your Drs. come to an agreement & solution for you.

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i'd like to resurrect this topic of low ejection fraction measurement without symptoms.

I'm a 78 year old male. I have a very high calcium score first measured in 1997 ( Heart Check America). It's higher now.

Almost 20 years ago I was suddenly told that an echocardiogram reading set my LVEF at 25. I was healthy , active and in disbelief. Later , my LVEJ was reread as "normal".

Recently, soon after my Covid vaccine( Phizer) I was told after a CCT that my LVEF was 24% with a stroke volume of 51 ml. I was strong then...am stronger now. My apartment is up 14 steps which I traverse numerous times per day. I exercise walk 1 to 1.5 miles 7 days a week and walk another .5 to .75 miles doing normal activities.
I'm totally stumped on the usefulness and accuracy of these ejection fraction numbers.

Anyone out there have similar experience or have an explanation ?

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@pumaguy79

i'd like to resurrect this topic of low ejection fraction measurement without symptoms.

I'm a 78 year old male. I have a very high calcium score first measured in 1997 ( Heart Check America). It's higher now.

Almost 20 years ago I was suddenly told that an echocardiogram reading set my LVEF at 25. I was healthy , active and in disbelief. Later , my LVEJ was reread as "normal".

Recently, soon after my Covid vaccine( Phizer) I was told after a CCT that my LVEF was 24% with a stroke volume of 51 ml. I was strong then...am stronger now. My apartment is up 14 steps which I traverse numerous times per day. I exercise walk 1 to 1.5 miles 7 days a week and walk another .5 to .75 miles doing normal activities.
I'm totally stumped on the usefulness and accuracy of these ejection fraction numbers.

Anyone out there have similar experience or have an explanation ?

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Hello @pumaguy79

You do present a puzzling question. I can certainly understand that you would like some answers. It appears from your post, that you basically feel OK despite the EF numbers. Is my understanding correct? Do you have any heart valve problems or any arrythmia problems?

While we wait for others to respond to your post, I'm wondering if your cardiologist has provided any insight to these changes in your EF?

REPLY
@pumaguy79

i'd like to resurrect this topic of low ejection fraction measurement without symptoms.

I'm a 78 year old male. I have a very high calcium score first measured in 1997 ( Heart Check America). It's higher now.

Almost 20 years ago I was suddenly told that an echocardiogram reading set my LVEF at 25. I was healthy , active and in disbelief. Later , my LVEJ was reread as "normal".

Recently, soon after my Covid vaccine( Phizer) I was told after a CCT that my LVEF was 24% with a stroke volume of 51 ml. I was strong then...am stronger now. My apartment is up 14 steps which I traverse numerous times per day. I exercise walk 1 to 1.5 miles 7 days a week and walk another .5 to .75 miles doing normal activities.
I'm totally stumped on the usefulness and accuracy of these ejection fraction numbers.

Anyone out there have similar experience or have an explanation ?

Jump to this post

Hi Pumaguy79, I was also diagnosed with a Low EF back when I first found out I had developed an enlarged Heart. This was for me was a result of a bad flu bug that caused fluid to build up around my Heart and Lungs. But it definitely had symptoms. Mine tho at its lowest was at 5 % and required the inserting of a pacemaker and some medications to help strengthen my heart. This was over 15 years ago now and during that time my heart did regain some strength up to an EF of the high 40's to low 50's. Now my damage was more predominant and caused other problems with arrythmias. Yours don't sound that bad as an EF is considered to be called CHF when it goes below 30. The main problem usually is fluid retention. The heart is the device that helps to push fluid out of the Lungs and when it gets low below 30 typically, they will put you on a diuretic like Lazic to help remove some of that fluid from your body. My next thought is have you reached out to a Cardiologist to oversee this problem or is your Regular Doctor handling this condition. I would suggest if you haven't seen a cardiologist yet to do so and most likely it can be managed before getting worse. If I can help with any questions, please ask as I delt with this for about 10 years and quite familiar with living with CHF.

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Seth250,
Read up on Coenzyme Q10 and Carnitine.
Harry

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@hopeful33250

Hello @pumaguy79

You do present a puzzling question. I can certainly understand that you would like some answers. It appears from your post, that you basically feel OK despite the EF numbers. Is my understanding correct? Do you have any heart valve problems or any arrythmia problems?

While we wait for others to respond to your post, I'm wondering if your cardiologist has provided any insight to these changes in your EF?

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Thanks, Teresa. I've got blockages for sure and right branch bundle disturbance.

I can see where lack of symptoms might hide angina pain, but nothing explains my ability to walk, climb stairs and do all of life's activities.Well, I take that back.
Noted author and San Diego cardiologist,Dr. Howard Wayne, described the heart's ability to revascularize itself to "bypass" clogged and blocked arteries.
These tiny arterioles are completely invisible to the heart cath imaging , but they can do a lot of work nourishing the heart muscle. I believe he was right.

But then, I get this low LVEJ reading that is so deeply inconsistent with my sense of well-being. And of course, an alert and concerned cardiologist has to
recommend a trip to the cath lab; and I have to keep refusing given my daily health experience and given the common practice of upping the game from
Cath lab to surgical suite.

And so it goes.

Thanks !

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