Cause of low EF with no blockages or plaque?

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

You may find this Mayo Clinic summary helpful as you wait for others to comment.
-Ejection Fraction: What Does It Measure?
https://www.mayoclinic.org/tests-procedures/ekg/expert-answers/ejection-fraction/faq-20058286
Lizzyhope, what led you to get and echo and CT angiogram? How are you feeling?

@jlharsh -my primary Dr heard a murmur and ordered the first echo, it showed low EF and other valve issues (I posted on those details a few months ago). Prior EKGs had also shown valve issues. That led to a cardiologist visit with another echo done after a few months on medication (no real change), and that cardiologist ordered the CT angio based on the low EF and a very strong family history of congestive heart failure. I've posted on all of that previously so trying to be brief here.

Wondering if your Echo showed any regurgitation, meaning backflow through a valve. A valve issue can definitely be a cause of low EF, but not sure what else would cause low EF.
All the best getting it all figured out!

@lizzyhope
My most recent echocardiogram showed low normal EF of 50-55%. It used to be 60-65%.
3 years ago I got a new aortic valve after a gradual decline in valve function with severe aortic stenosis. I was fine afterwards until my recent echo. I asked my cardiologist for the cause of the lower EF. He thought it could be due to the strain on the heart from the aortic stenosis.
It probably would be a good idea to have your valve issues examined.
Do you feel a change in your stamina?

@aard yes--3 valves showed moderate regurgitation. thanks, that's helpful to ask my new cardiologist more about.

@astaingegerdm -thank you, this is helpful. I still (make myself) exercise daily-but stamina has decreased for sure over the last year or more.

Mine was 47 on first Echo. Next Cardiologist visit I was prescribed ENTRESTO. Also got Doc’s OK to increase my exercise levels. Following year the EF improved to about 65.

@lizzyhope
I see many post after your original. Wife had surgery so not been on MCC lately.

I have had a low EF for over 25 years. When first had test done my EF was 48%. Normal is 50%-70%. So your lates numbers are quite good and would suggest you keep doing what you have been doing.

When I was diagnoses with heart failure (HF) in 2000 I was told had a LBBB. I had the same test as you and my Catherization showed no signs of cardiovascular disease so it was determined I had cardiomyopathy probably caused by a virus or infection in heart causing scar tissue and the cause of my LBBB.

LBBB, PVCs, and other issues can cause the heart to get bigger trying to compensate with a lower EF (This all by my EP) that the heart gets larger. The larger it gets the inability to contract completely thus the lowering of EF.

I can see you have been getting a lot of answers from your medical professionals and hoped that answered your questions. From what I read a lot of your EF and Heart Failure from valves. But if your HF is 50 or above it is a normal EF.

I wish I was even close to your EF. I am presently at 22%. I have been a 22% for over 10 years. I contribute this to Entresto and Coreg. And my own dedication to exercise every day for 1-2 hours. And yes my HF doctor said to me, "the reason you can do the things you do and exercise is that you were an exerciser all your life and your body was able to compensate for the low EF."

Good luck, looks like you got most of your questions answered by your medical professionals and those on MCC

My heart issues stem from congenital VSD (opening in wall of Ventricle) and WPW. Being born in 1959!, that wasn’t easily corrected back then.

However, by 2000 cardio problems started accumulating and it’s been a continuing decline since then ( I won’t bore you with details).

A transplant team at Mayo Jacksonville has been following me since 2021 and I have to say that their care has been outstanding for a remote patient like me.

I’ve learned that HF has many possible causes and that cardiac care has really progressed over time.

It sounds as if your issues have been detected fairly early and I hope that is a good thing for you over the long run. Keep a positive outlook and take care of yourself.

@jcblubaugh
I am a patient of heart failure/transplant since 2006. I have been see Dr. Yip since 2006. Mayo Jacksonville has outstanding specialists for heart failure and those who need, have had, and recovering from transplant. Just wish they could keep their office in Mayo Building instead of Davis as really like Mayo Building offices more.