Chances for further improvment

[sharyn5]

I am 49 yo female diagnosed with DCM in August of 08.  My EF was 20% upon cardiac cath.  No blockages, no leaky valves.  Final conclusion: DCM caused by a virus.  I have had three Echos done since then... EF 35% then up to 43% and holding stable.  NO SYMPTOMS.  I am on Coreg, Digoxin, Lasix, Quinipril, Potassium (i think thats the list in full).  My question is... I am 6 months out from diagnosis... Can I still gain improvment or am I  going to have to settle for the EF at 40%?  I am scheduled for a MUGA in May because of my LBBB they feel they can get a much more accurate EF with the MUGA.  Also, When do you reach a point when you can comfortably feel that you are in the 1/3 that will stay the same??? or the 1/3 that will get better??? I would appreciate your input.  

[Dr. Kokil Mathur]

Well, if it is of viral origin (usually it is coxackie B virus) then maybe the viral infection can be treated. This only your treating physician can judge. Yes, drugs, low salt diet, exercise as advised and rest will help you to remain stable. See a stretched heart muscle is like a stretched elastic band. This cannot go back to its pre-stretched state. However all measures can be taken to see that it does not stretch further. Hence you are put on drugs which improve the heart’s pumping function, reduce symptoms and prolong life. If there is an identifiable cause for the DCM then this should be looked for and treated like—viral infection, bacterial infection, poorly controlled diabetes or thyroid disease, morbid obesity or persistent rapid heart rate.
Please discuss this with your doctor. Please let me know if there is any thing else and do keep me posted. Take care!

[sharyn5]

Dear DoctorNee, I so appreciate your answer.  I am a bit confused on your statement that "if the DCM is of viral origin then the underlying cause can be treated"... do you mean they should be treating the virus???  I am just abit confused by this statement.  
Also you say my aim should be to remain stable - I am assuming the best way to do that would be to take all meds, excersise and watch the diet?  Is there something else I can do to help with stability?  Thanks so much for your answers!

[Dr. Kokil Mathur]

Hi
Thanks for writing to the forum!
A LVF of 40% is quite good. One can carry out all normal day to day activities without any fatigue or exertion. Yes, MUGA Scans can help measure the ejection fraction better.
In your condition the aim should be to remain stable and not decline. Any improvement is always welcome. If the DCM is of viral origin then the underlying cause can be treated.
It is difficult to comment beyond this at this stage.  Please let me know if there is any thing else and do keep me posted. Take care!