My hushand has been a diabetic for approximately 30 years. Recently he has suffered 3 bouts of congestive heart failure in one year. His ejection factor is 28%. What is his life expectancy? He is on many medications and uses oxygen daily. In the days 2 units and at nights he is 3- 4 units.
Ejection fraction is the amount of blood ejected from the left ventricle into the systemic circulation per beat. Normal values are in between 55-70%. A low ejection fraction does not by itself mean reduced life expectancy. Other measurements may show increased risk for death - a high QRS interval, high CgA level, low heart rate variability, T-Wave Alternans, very low Vo2max, etc. Medication therapy, low-sodium diet, well-planned exercise, and other life style changes such as stopping smoking, stopping drinking and losing excess weight can help improve ejection fraction. Hope this helps. Best.
The underlying cause for the low EF could provide more information regarding prognosis. About 6 years ago I was hospitalized with CHF with an EF 13-29%. I had a dilated left ventricle that caused the systolic impairment.
Treatment to reduce the heart's workload enabled the heart to reverse remodeling, and today my heart is normal size and EF is 59%. What happens with CHF is the heart does not have the strength to pump into circulation the amount of oxygenated blood received from the lungs. This causes blood to back up in lungs and fluids leak into the tissues.
An EF of 28% should be adequate to pump sufficient blood into circulation if the demand for oxygenated blood is reduced. Heart failure range is below 30%, but there are estimates of about 25% individuals of the heart disorder population perform their daily activities without knowlege of a medical condition and not being treated. I did not know I had a heart problem until I had CHF symptoms.
Thanks for sharing, and I wish you and your husband well. I know you are under much stress, take care.
Thank you for taking the time to respond. My husband's EF is due to the fact that his heart muscles are weak due to the fact that he has been a diabetic for a long time(my evaluation) His entire body seems to be breaking down despite the many interventions of Medical Doctors,Naturopath, Chiropractor, massure, natural remedies . I am afraid of the outcome.
I have one question for ya. You already know that my EF was 27% so its technically in the heart failure range. Now, is CHF just more of an acute problem when the fluids build up? I read that here in the info on it, and wondered if that was the case. I now am on a potassium sparing diuretic and my doc did say it was the best one to help with CHF. So, do I technically have CHF with my DCM or are those terms interchageable at this stage? Or is CHF more of an acute thing when the fluids build up to dangerous levels? I did read to not exercise when the fluid is there... and that makes sense, since when I do exercise, I already get some fluid gain... that has always been the case and RA can cause that to happen anyway. So, I will avoid that. But, I always have the fluid in the morning and then the diuretic seems to help thu the day. But, I think I need to call to get my dosage raised... since some days it just doesnt help. THose are the days I have more DCM symtoms (symptoms) too... and feel awful.
Anyway, I knew you could answer this...
thanks, take care and hope you are feeling good today!
Good questions. Technically, one is in heart failure mode with an EF below 30% as knowledged by SSA and some insurance policies, etc. The condition of heart failure can be chronic without symptoms (no angina, fatigue, shortness of breath etc.), and with a triggering event can go into congested heart failure...the prevailing symptoms would be pulmonary congestion with a dry cough, shortness of breath, etc. That's my experience.
MedicineNet: "Many people with DCM have no symptoms or only minor symptoms, and live a normal life. Other people develop symptoms, which may progress and worsen as heart function worsens."
Yes, technically you have CHF with your DCM when you have pulmonary edema (congestion).
Hi, I was dx with heart failure due to cardiomyopathy 10 yrs ago, (age 48). My doctor put me on Coreg,(was a new med at that time) and it saved my life. Coreg also lowers the heart rate and helps the heart to pump more blood with each beat, basically it helps the heart from wearing out so quickly. It took a few years but now my ejection factor is up to 55. The only issue I have now is the top left part of my heart remains slightly enlarged and my valve is leaking.
I wish you and your husbad the best and don't give up hope, sometimes it just takes awhile.
yeah! Another success story! I am on 40mg of Coreg (and Lisinopril) so I hope it works for me too!
to Kenkeith, thank you for the reply. I do have shortness of breath a lot and a dry cough. I noticed some water gain for a few days that didnt want to go even via the diuretic. I thought I just put on a few lbs. Then, Friday, I had a bad episode all day from my heart... shortness of breath and chest pains. I had to sleep most of the day. When I slept for a few hours after taking my diuretic, those few lbs were gone! So, I know that it was really water. Those days preceded that episode. Its hard to see what is really going on since RA can also cause water retention during swelling of joints. Ugh! Anyway, I almost went to the ER but was better the next few days. I probably should call my nurse and tell them about that event. I was bad when laying down and sleeping... couldnt get my breath. I just dont know how to tell if you have fluid around the lungs when I have the dry cough a lot of days and shortness of breath. Is there another way to tell or do we just have to go to the ER? I hesitate to go sometimes since I have to pay a LOT for one visit there. Of course, I want to save my life too... but I am just not sure how to tell when to go. If I ever call my doc (nurse rather) and tell them I am in bad shape, they just say, go to the ER if you are that bad, even during business hours. Then the ER has told me on two visits to just go to my doc the next day! Doc office says, go to the ER, the ER says, go to the doc! razzafrazza!! (my diuretic might need to be upped on the dosage too... have to call today and ask)
Anyway, if you have any info on what else to look for, let me know. In the meantime, I hope I am getting better! I worry since I have so many symtoms (symptoms) without exertion like it has been from the beginning... but of course, I have positive outlook and hope! :)
I have an EF of 15%, with stage 4 heart failure, stage 5 renal failure, and CHF pops up ususally when I get a little complacent about my diet.
Salt is my Frankenstein, and seems to be at the bottom of all evil with reocurrence of CHF when it's least expected.
I've been to the ER twice in the last 6 months for CHF and I think I can safely say that if you need to see a doctor in the ER you will know it. You will not be able to take a good breath, nor feel any benefit from trying to breath. It is then that you'll need to get to the ER and have a breathing treatment, which will reopen your lungs and dry them out. Don't try to drive yourself, and if you have no one to take you, then call an ambulance.
One thing I have learned over the last 3 1/2+ years is, when I start having troulbe, or start feeling the symptoms of CHF, I stop, take inventory of exactly what is going on. Then if I find that breathing isn't do me much good, I head for the ER, otherwise I take an extra lasix and a wait and see attitude. Sometimes the extra lasix is all I need to pull the excess fluid out of my body, other times I just can't get a good breath, and the latter is a red flag for treatment in the ER.
My HR at rest is usually around 80 or 90. I used to take Nadolol for a mild form of tachycardia for years since it would get high at rest. It would get the HR down further than the current meds, but of course they are super important in my new situation. My HR with the shortness of breath? I need to check it more during those times, but it can be around 90. Its just that feeling of not getting any oxygen. That day I was really bad a few weeks ago, even laying down and sleeping I felt so short of breath. I think I should have probably gone to the ER that day. I sure felt like I should have. Luckily, it did get better.
Now, I seem to have problems getting rid of edema, when I didnt at all a month ago or so. I wonder if you can get into a rebound effect from the diurretics? I just switched to Lasix from the other one. They both seem to get rid of water for a few hours and then it comes right back.
"Other measurements may show increased risk for death - a high QRS interval, high CgA level, low heart rate variability, T-Wave Alternans, very low Vo2max, etc"
how do I get these results? Are they found on reports from the tests I get done? Stress Test, Echo and MUGA? I need to ask for a copy of my file.
My doc didnt even tell me my EF till my Rheumatologist asked me what it was... and then they only sent it to her. I had to get it from her. I think if I would have asked my CD the next visit, he would have told me, but I think he should have let me know when he gave me the diagnosis.
I take it that the meds did not help in your case then? Did you take the usual ones? I feel like I am getting worse sometimes. I am due to find out in a month. Did you have to get an ICD?
I had no idea a hospital could do that kind of lung treatment, thanks for the info. I was bad enough that day to go. What bugs me is that the ER's in this city are notorious for being horrible. I went in for super high blood pressure and HR a month or two before showing signs of DCM and they did NOTHING helpful. I even had to go back two days later since I was the same, and they still just gave me meds and watched as the BP monotor beeped and beeped when too high. I paid them almost a thousand dollars for those two visits... and no heart tests done but for an ECG and my rhythms are always normal. Ugh!
Then, on an unrelated event, I went to another ER for angiodema not too long ago, swelling in the face from some reaction. They did even less... giving me prednisone and benydril which I had at home! I could have done that. I was more swollen when they told me to go home than when I went in. They got over 400 dollars from my insurance for that.
Sooo... I am leary of the ER actually doing what they should. At least I know what to ask for. It also frustrating since they never call one's docs or specialists when you are in there, unless its a long stay.
Rambling on there... anyway, I do have a thing with salt too. I have been watching it more closely than I already was. My prob. is that I love hot salsa and peppers in jars and those have so much salt, so I have to limit them and count the salt. Salsa has a lot too but I found one that was low enough, but of course its not as good.
I hope you are ok. Is there any hope that you will get better at all? My heart goes out to you, no pun intended. Take care.
I honestly don't know if there is any hope for me or not. My doctor doesn't talk about dying because it has a negative effect on me.
With the renal failure, I could live for several more years, provided I do well on the dialysis and follow my diet. However, the EF of 15% isn't very promising. I am scheduled for an implant consultation next week, but who knows what good it will do.
The Coreg didn't work for me like it was suppose to, but I'm still alive, and that's a positive. I now take Enapril, diltiaziem, lasix, and coreg, and at times my BP is around 80/40, which leaves me feeling dizzy and weak. I feel my best at 120/70, but my BP is allover the board most of time.
Yes, the salsa probably isn't helping you at all, but I know how hard it is to give up something you love. I've been changing my lifesyle a little at time for over 3 1/2 years, and now I'm getting flak from my dietician because she thinks I'm too thin. She is pushing meat with no salt, and expecting me to eat a ton of it. I might as well be eating cardboard. I would rather have fruit, veggies, and sweets, of course, but renal failure takes it toll on muscle mass, and the only way to combat it is to eat lots of protein. I don't eat eggs for reasons I won't go into, but all that leaves is meat, since cheese is too high sodium.
I would love to bite into a huge piece of sausage pizza right now. :)
I am sorry, I hope I didnt ask that with insensitivity. I didnt mean to. I hope I didnt have any negative effect on you either. It can freak me out to have EF of 27% and the other diseases I have, but I shouldnt complain so much.
Yeah, I hear ya about the protein. I eat more veggies and fruit than meat and would feel the same way.
mmmm... pizza. I indulged in some the other day... I only add tomatoes to mine, but still the sodium there. I didnt even know that things like milk have so much sodium! I never would have thought to look at that. Everything has so much of it!
Hope your consult goes well. Let us know how it goes.
wow, I went to the nearby mountain for an afternoon the other day and elevation is around 8000 ft for the area we went to... just to have picnic and be with the trees... but whoa! I had the hardest time breathing. I expected the elevation to make it a bit harder, but it really hit home how bad I was doing. That was a bummer but I still managed to enjoy it. My RA was acting up too so it was hard to move. Geez- all at once.
I really hope my meds are working but worry when I have so many short of breath days even at home at rest. I will keep a positive attitude tho!
I am 73 yrs old and have EF of 22% for 10 years. I am relatively asymptomatic (no apparent external symptoms). I have an implanted CRD device for 8 years and my meds are coreg, quinnipril, inspra, and lipitor. My BP is 110/70 with pulse between 62-68.
Just learned from pulmonologist that anything that ends in "pril" can cause a chronic cough. My mother, age 83, who is being treated for CHF was placed on Lisonpril and was coughing to the point where sleep was interrupted. Pulmo had us contact cardio, who stopped medication, and the cough is gone! There are other medicines that do the same thing as Lisinopril and do not have cough as side effect.
that is one of the few encouraging words I have heard. I had a heart attack 6 weeks ago and after many tests they did confirm it was a heart attack. My blood pressure was normal, my blood oxygen 97 at time I was admitted and no blocked arteries. But did have damage to left ventricle with 20% ejection fraction. Is that determined by the ECG or blood test?
I quite smoking and drinking 20 years ago and am losing weight but not heavy anyway. I am hoping that I can get the EF up higher n next few months so I dont have to have a defib put into my body.
Whats your feeling about internal defibs?
I am almost 52 years old and have an ejection fraction of 18-21%. Doctors felt I needed a heart transplant but because my aorta vessel is calcified, I have been denied the transplant.
To know you are 71 and have lived 10 years with an EF of 22% gives me hope. The whole EF number freaks me out. I know I need to do better with my sodium intake but I am exercising three times a week at a Rehab Center. Anyway you give me hope.
Hi there, I'm a 44 year old diagnosed with CHF Dec 18, 2014. Cardiologist figured he would humour me by doing an echo as he plugged me into his iPhone app and I came back as extremely low probability for chf. Unfortunately the joke was on him. Or is it on me? I'm also a nurse in the hospital where I was seen. My EF is at 28% so I know exactly where you are coming from. Not a heavy drinker by any means, had recently quit smoking before this all happened and none of the obvious signs other than becoming so short of breath. At this point they think the cause was a virus that attacked my heart. I amonth still waiting for a CT angiogram to rule out coronary artery disease as the cause. Either way nothing really changes in the treatment plan unless I should become extremely worse and require a transplant.
Recently I chatted with a friend I met online. He was diagnosed 2 yRd ago at 54. He came into ER and was basically dead for over a minute. They got him back and he had an EF of 15% . He went to ICU. Family was told to say their goodbyes. He's doing well now on the mess with an EF of 28%. It's a hard diagnosis to take that's for certain, but you can live with it! My biggest learning curve has come with dealing with the lasix/water pill but that's getting better. That and having to realize I can't do everything I used to do! Learning to live within limitations is hard, but when all you have done is give and give I guess life has a way of slowing you down. Good luck to you!
I am 67, dx 2 yrs ago with CHF, ejection of 15%. Had no idea & no symptoms to speak of until I couldn't get my breath while visiting our son out of town. Three months later I got a defibrillator, which gives me a little peace of mind that it will start-me-up if the old ticker gets too tired! I started cardiac rehab which made me feel so much better, more energy, though I'm still pretty limited in what I can do. My ejection improved to 19% in a year so I'm going in the right direction! I still watch my salt though it's so hard. You have to just do the best you can: diet, medication & reasonable exercise. Can't dwell too much on it, still getting used to a new normal - but I'm thankful each morning to wake up & see a new day.
It has been a while since I have been out here. I so appreciate you responding. My doctor will NOT repeat an echocardiogram as he tells me it will not change his treatment and I get hung up on the EF. We will be moving to Vegas in less than a year and I am terrified about changing doctors. My hope is to be able to live another couple years so I can celebrate my 25th wedding anniversary. It is just nice to hear from someone that has some of the same fears as me.
My husband was medically retired from the military after having lung cancer and undergoing a right pneumonectomy a clinical trial at NIH using high doses of chemotherapy and radiation to the mediastinum. He was not expected to live however he has been alive 19 years but has developed a number of conditions all connected to the above to include the latest CHF. He recently had a left and right heart catheterization which showed his pressures were fine and his arteries had less than 10% blockage but he had a lot of scar tissue in his heart with a EF of 30-35%. He has been on Lasix for a number of years but still continues to have fluid build up. The doctor is not sure of what may have caused the scar tissue and when he compared echos from one year ago the doctor gave us the impression that this damage occurred within the past year. Our concern is if this is true how do we stop more damage from occurring? We are going for other doctors for second opinions but do you have any suggestions?
I am 66. I have had RA for 45 yrs, many joint surgeries and now my inflammation is pretty well controlled with Remicade infusions. Only have "mechanical pain" from the past destruction of joints.
In the heart dept., I have had extra heart beats for over a decade and my BP is just slightly high.
About 1 1/2 year ago, my EF was 50. Last month, it was 40-45. (I still have to go next week for the results of the images taken last week when I had a stress test). I have no symptoms. Someone mentioned in this forum having RA. Is RA related to a lowering EF or could the meds for RA be responsible? Thanks so much for some answers!
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