Question about LVEF after Heart Failure

[Bluefl0wer]

Hi

My mom, who is 73 years old,  had heard attack around 3.5 months back.   At the time of attack, the LVEF was showing 40%.     A single major block with 99% in the left artery was the cause of the heart attack, we went ahead with a stent angioplasty and the blockage is cleared.

From day one after the attack and angioplasty, she is regularly taking Cardivas (Coreg), Lasix, Ramistar (Rampril), Ecosprin (Asprin), Ivabradine (Procoralan), Tonact and Planep.

However, she developed some chronic coughing for the last 2 months.   When taken to the Cardiologist again, he asked for echo again, which showed the LVEF improved to 42%.   He said it is due to the pumping, and the congestion is not clearing, prescribed some antibiotics for clearing the lungs.

Despite taking too many medicines, my mom is pretty disappointed to see that the LVEF got improved only by 2% from 40% after 3.5 months to 42%    How long it will take to improve the LVEF to an optimum level of 50%?    

[Bluefl0wer]

She is lot better now.  The coughing is completely gone 5 days after stopping the Ramipril.

Thanks again!

[jrbon]

Yes,

The cough it is produced because the Ramipril destroy the Bradiquine in the lungs and it takes some time to replenish it, but it should not take too long.

How is she now?

Jesus

[Bluefl0wer]

It is just one day after my mom skipped Ramipril, and still continue to have the cough.

The doctor was saying the cough will not stop immediately after stopping the Ramipril, will take at least a week to reduce.   Is it correct?

[Bluefl0wer]

You are spot-on.    When I took my mom to the cardiologist few days back, and asked about the chronic coughing, he immediately asked to stop Ramipril.

Thanks for letting me know.

[jrbon]

Depression it is very normal after a HA, check with her dr. and he will prescribe some depression medication.

EF of 50% is the limit of "normality" but it does not mean that you cannot live with much less (my last echo was 17%-20%).

For heart patiences, the normal diet is to limit fat and salt. And make 5-7 small, very small meals per day.

Jesus

[Bluefl0wer]

Please read "between 6-3 months" as "between 3-6 months" in the above post.

[Bluefl0wer]

Thank you jrbon.   Yes, we are completely aware the part/size of damage of the heart muscle will have the impact on the LVEF.

You have mentioned the biggest part of recovery takes place between 6-3 months.     After the HA she had, last week was the first time we took the echo, which is precisely 3 months and 2 weeks after the HA, with an increase of 2%.   Is it too early to predict by looking at this measure?   I heard the ejection rate anything greater than or equal to 50% is good.    

At present she is very depressed, not eating properly.    She is a vegetarian.   Do you think any healthy diet can improve her better, especially for the heart?

[jrbon]

By the way, if after clearing her lungs, she still has a dry cough, the reason could be a side effect of the Ramipril.

Jesus

[jrbon]

I am sorry to tell you this but a Heart Attack always means that a part of the cardiac muscle has death (otherwise there is not a HA). That means that  depending on how big the HA was( affected area)  and how long it took to restore the coronary circulation the permanent lost of EF can be more or less.

Normally there are some chance of recovery until 1 year of the HA, although the biggest part it is usually in the first 3 - 6 months.

The good news is that with a 42% of EF she should be able to live a quite normal life with little or none limitation.

Jesus