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low ejection fraction buy no symptoms?
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An_247728 posted:
Hi I am new to this group and worried to death over my husbands health. He is 60 and in good health aside from the heart issue, 5 years ago said he felt dizzy and that lead him to a cardio dr - short of it is: family history of heart disease (dad died at 77 of heart attack, brother is 66 and has ICD). Husband is non smoker (was about 15 years ago though). has had 2 angios in last 5 years which show no blockage. BP is very good. There is damage to left side of heart but we don't know why or dating back to when- some drs say caused by alcohol (husband is european - common to drink 1 bottle wine every night with dinner) OR genetic/hereditary.. I have taken him to multiple docs - an electrophysiologist saw alot of PVCs saying that could have been cause all along for the heart damage and never picked up before - she suggested ablation - which cut the PVS" in half (but they are still on higher end - there is discussion about a repeat. He is on coreg, lipitor (preventive) lisinopril and baby aspirin. His Ejection fraction in 09 was 40% (MUGA) and now last echo showed it as being 20 - I have requested a MUGA to compare apples to apples. The want him to have an ICD b/c EF is so low as his "guardian angel" He was drinking for a while a few months back on a regular basis EVEN THOUGH HE WASN"T SUPPOSED TO! (sometimes 3 per day) and I have convinced him to NOT drink at all as the dr was saying this is basically LETHAL. He has stopped. He has no symptoms - no cough, no swelling, only out of breath when he climbs 3 flights of stairs (me too!) , has a job where he walks around alot...so my questions are: 1) how can EF be this low with no symptoms? Dr said this is the case with some people..2) he is on good meds, had the ablation which reduced the PVC;s, could it have been the drinking that was continuing to decrease the EF? 3) if it WAS the drinking can he improve his EF? what else should he be doing? right now he sees his electrophsyiologist more than his cardio dr b/c of scheduling issues - is the cardiologist the one who will be best to advise us about the EF issues? any advice appreciated. He is very laid back about all this - I am stressing out to the max! orry for the long post - part of me is afraid to even read the responses......
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cardiostarusa1 responded:
Hi:

"Is the cardiologist the one who will be best to advise us about the EF issues?"

Yes.

......"saw a lot of PVCs saying that could have been cause all along for the heart damage."

Seems highly unlikey, as PVCs are typically benign, though anything medical is possible today.

"His ejection fraction in 09 was 40% (MUGA) and now last echo showed it as being 20..."

An LVEF of 20% is considered as severe heart failure.

Pertinent article excerpt from about.com - Heart Disease, with Richard N. Fogoros, M.D.

When is the MUGA scan more useful than other heart tests?

The advantages of the MUGA scan over other techniques (such as the echocardiogram) for measuring the LVEF are twofold
. First, the MUGA ejection fraction is highly accurate, probably more accurate than that obtained by any other technique. Second, The MUGA ejection fraction is highly reproducible. That is, if the LVEF measurement is repeated several times, nearly the same answer is always obtained. (With other tests, variations in the measured LVEF are much greater.)

"How can EF be this low with no symptoms"

Some individuals who have a low (moderate) or a really low (severe) LVEF feel fine and function well, while others do not.

As applicable, in some cases, along with a doctor recommended/authorized exercise regimen (unless contraindicated), LVEF can be increased, sometimes substantially, by customizing/tweaking prescription drug-therapy (such as, Coreg, which he is already on, which showed, back in its clinical trial days, that it could boost LVEF in some individuals) and supplemental (complimentary or integrative medicine) therapy, as deemed applicable.

Just one example of complimentary medicine is the use of the supplement Coenzyme Q10 (CoQ10 or ubiquinone, a vitamin-like substance) for heart failure (though currently not scientifically proven, some doctors may advise the patient to give it a try) which may/can (i.e., along with doctor directed prescription drug-therapy, and with the doctor knowing about any supplements being taken) help to improve LVEF in some, with other supplements sometimes added to the mix as well.

Cleveland Clinic

Understanding Your Ejection Fraction

http://my.clevelandclinic.org/heart/disorders/heartfailure/ejectionfraction.aspx
"They want him to have an ICD..."

It is often said that an implantable cardiodefibrillator (ICD) is like having a rescue squad inside your chest.

As demonstrated in clinical studies, and as deemed applicable (meets the current criteria/guidelines) to the patient, in some cases, especially in those with a low (moderate) or very low (severe) LVEF, an ICD can improve the outcome (especially if/when the heart's electrical system goes haywire).

Best of luck to your husband and you down the road of life.

Take care,

CardioStar*

WebMD member (since 8/99)

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Be well-informed

WebMD/Cleveland Clinic

Living with Heart Failure

http://www.webmd.com/heart-disease/heart-failure/living-with-heart-failure

Forum: Heart Failure

http://myportal.americanheart.org/jiveforum/forum.jspa?forumID=16

Heart Failure Society of America

Heart Failure Stages

(Class I-IV)

http://www.abouthf.org/questions_stages.htm

Heart Failure Center

Stages of Heart Failure

http://www.heartfailurecenter.com/hfcheartfailurestages.shtm

Classifications of Heart Failure

http://www.heartfailurecenter.com/hfcheartfailureclassifications.shtm
Patient resources

Implantable com

Website provides a focus for information related to the field of implantable pacing and defibrillation.

http://www.implantable.com

Pacemaker Club

Our purpose is to help cardiac pacemaker and implantable cardioverter defibrillator (ICD) recipients meet, share information and support each other.

http://www.pacemakerclub.com

LifeBeat Online

An e-newsletter created to help people with cardiac devices and heart or blood vessel conditions live full, active lives.

http://www.lifebeatonline.com

.

WebMD/WebMD forums DOES NOT provide medical advice, diagnosis or treatment.

WebMD DOES NOT endorse any specific product, service or treatment.


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