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@redhead63
I was diagnosed with Cardiomyopathy. When they first discovered a low EF they did a catherization on my coronary arteries. They did not find any cardiovascular disease. But my hearts electrical system was all screwed with LBBB.

We did a history of any illness right before the LBBB was discovered. reported a serious virus infection just before the LBBB was found on a routine EKG. My doctors said most likely virus got onto heart and caused scar tissue.

My EF kept going lower lower and my local cardiologist said once EF gets to 30 we recommend seeing a Electrophysiologist (EP) for a ICD device. I chose to get a second opinion at Mayo Clinic Jacksonville. There I met with EP who diagnosed me with same cardiomyopathy and suggested a dual device ICD/Pacemaker. He said pacemaker could help with electrical issues and the ICD would be there if heart went into tachycardia.

He referred me that same day to the heart failure specialist at Mayo. He recommended changing my medications to Entresto and Coreg. I then made decision to change my care to Mayo Jacksonville and followed all the procedures and medication they recommended.

My EF by that time was 22%. With the pacemaker, ICD, and new medications my EF has been the same for over 20 years.

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@jc76
You definitely have a lot going on and my situation is much different from yours.
My HFPEF is caused by having Ehlers Danlos Syndrome, Microvascular Dysfunction and exercise induced hypertension