What does it mean to have CHF diagnosis, symptoms, normal echo?

@mikeydc2008
Usually the echocardiogram will give you the Ejection Fraction (EF). This is the prime (per my heart failure doctor at Mayo) to determine if you have heart failure (HF).

Per my heart failure doctor and electrophysiologist the normal EF is 50-70. That is a statistic though and does not reflect what is normal for you. But what doctors use (again not an opinion but what is told to me by my medical doctors) is once it goes below 50 then consider HF.

So important to know your EF. Regarding CHF. I think what I have learned over having HF diagnosed since 2001 is they use this diagnosis when you have HF. I don't agree with that and have challenged that (CHF) with my doctors and that is when I was told HF patients get lump into a overall CHF status. So you can, and definitely for me technically can have HF because of your EF but not have CHF symptoms.

I exercise every day 1-2 hours. I do water aerobics (high level) 5 days a week taking 7 classes in all. I swim 1-2 twice a week 1/2 mile, and ride my bike 15 miles 1-2 times a week.

And yes I have HF. My EF is 22%. But has been that same % for over 10 years. I credit that with very good medications and the my pacemaker is programmed to pace the RV and LV to optimize the best EF they can get using each side contractions to increased EF.

@jc76 — Thank you! I am amazed you are so athletic now! WOW! That’s Impressive! Were you always so athletic? And how are you able to exercise so much? How much of your exceptional abilities do you attribute to your medications and how much to your pacemaker? I am trying to treat my presumed CHF (but 60% EF). I was diagnosed 2 years ago. I am doing well, but my exercise is still limited. I am thinking about trying to jog and workout again. My echocardiogram was normal in every way. However, my ECG once again found I have an incomplete Heart Block. I am thinking about what to do next. I am told now I do not have Heart Failure (and never had Heart Failure). Instead, I have an incomplete Heart Block. And there is nothing I/We need to do about it (since it is just due to getting older). I guess the next thing for me to do is to go back to the gym again and start exercising more and harder but with someone around who can help me if I get dizzy, out of breath, etc.

@jlharsh — Thank you very much! My Congestive Heart Failure (CHF) diagnosis came from an Echocardiogram that found Diastolic Dysfunction 1 with symptoms (shortness of breath, swelling, constant weight gain while on a minimal vegetarian diet, high blood pressure, high cholesterol). All of a sudden I was really swollen and sore and couldn’t walk! I felt really bad! It was even affecting my thinking, awareness, and consciousness! So, now I am starting to focus on and emphasize my “abnormal” ECGs (Heart Block, but not complete yet). There is a Mayo Clinic close to me in Jacksonville, Florida. Everyone raves about how good the care is there. Exceptional!

Just a FYI: Cardiac Microvascular Disease ( Cardiac Syndrome X) can cause CHF with a normal EF - HFpEF.
MVD (MicroVascular Disease) is very common in women. The very small blood vessels in the heart are clogged with plaque and can not be stented. This can and does cause angina (heart pain). This condition can only be controlled by medication. And this condition can be systemic. Called small vessel disease and common with aging as well. I have both Cardiac MVD and small vessel disease in my brain.
A woman with this condition, and with a "normal" EF can go into CHF.
Yes, it's wonderful you are going (or with already) the Mayo Clinic. My personal feeling is - when it comes to your heart - you want to be treated by only the very best medical facilities in the country.
But truthfully I feel that way with any serious medical condition!
All the best to you.

@briarrose — Thanks! Best wishes to you!!!

@mikeydc2008
Yes an exerciser all my life. Played a lot of sports in high school, played sports when in military, and continued through out my adult life and not into my twilight years. I am 79 and get "wow" a lot when doing Sprint Triathlons.

I was on a military SWAT team and each year we traveled around the U.S. competing with other USAF military bases SWAT teams. We did a lot of firearms and scenarios but the physical part was tough. We would start (in full swat uniform) doing 25 obstacle course, then run 3 miles in our boots and uniform. I did that all through my 30's and early 40s as a federal contract employee at CCAFS.

The name of the competition was Peace Keeper Challenge. Out team repeatedly got gold metals in physical fitness and many of the shooting competitions. I kept doing them into my 40s. I only stopped when got hired by FEMA as a Special Agent Security Manager.

My heart failure doctor specifically noted my life long exercising as how my body adapted to having heart failure. I would give my left toe (small one) to have your EF of 60%. The norm is 50-70.

I have a LBBB since 2000. It was one reason for getting a pacemaker. When your heart (and this comes from my electrophysiologist) when EF gets to 30% they do a ICD. So they did a dual device for me as electrical and low EF issues.

Medications kept my heart failure from getting worse. My continuing to exercise kept my heart in shape as well as body. My ICD has at times shocked me. Once the pacing screw up and paced me, once I got dehydrated and the other times extreme stress.

I would with if you and with your doctors permission start of with what is easy and then slowly increase the intensity. I know mentioning water aerobics is a picture of elderly ladies with weights out of water. The problem with those videos is the weights are kept in the water to provide resistance. In my water aerobics classes we probably have 5-6 men out of 40 but some of the women out do us dramatically.

Some of our men will not do certain classes as are called high fitness water aerobics and they find it too hard to do all the exercises. I do water aerobics 5 days a week. On Mondays, Tuesdays, and Wednesdays I do back to back classed. It is why I swim on Thursday and Fridays as only do one class.

I think my exercising is great for me physically but I enjoy it mentally just as much. If I miss my daily exercising it is like missing a meal. For me is both a physical exercise enjoyment and a mental health therapy calming activity.