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Confused
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Confused

I am 28 years old. On March 18 I went to the hospital because of severe heart burn after some heavy drinking a few days before. Doctors performed an EKG just in case. It acutally turned out to be abnormal.  This has actually happened five years ago where the EKG thinks i have Periocaditis but according to my cardiologist  I do not.  They went ahead and performed an echo which showed ejection fraction of 50%, everything normal except for a small area being hypokinetic compared to other segmets.  Cardiologist at the hospital freeked out and told me i could be having a heart attack because my enzimes were also high.  They performed an MRI which showed mild wall motion abonormalities consistent witha cardomyathic process such as myocarditis.  They then decided that i should have a catherder done which showed my blood vessels as being as good as new but according to the cardiologist my ejection fraction was calcutaleted to be 40%.  He told me to come back in a few weeks and he put me on beta blockers, ACE, and digoxin. He also told me this is serious.

I went back to my original cardiologist once i got out of the hospital and 5 weeks later he performed a Thallium Stress test and Echocardiogram which showed my Ejection Fraction to be 55% and 53% respectively.  He told me my heart is 100% normal and disagrees with the other cardiologist and is planning on getting me off the medication within two weeks.  Do you think i should get a third opinion?  Does an ejection fraction fluctuate that much in 5 weeks?  Could it be that I had myocarditis and now its gone? Should i be concerned
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Dear Roycogliandolo,

You pose a very interesting question. You were diagnosed with weakening of the heart muscle and started on a beta blocker, ACE-Inbitor and digoxin. A subsequent re-evaluation 5 weeks later showed improvement in left ventricular function. It is possible that you experienced myocarditis which can present with regional wall motion abnormalities and reduced ejection fraction as you described initially. It is also possible for this to have resolved by the time of your next evaluation. This possibly could have been due in part to the medication you were taking or the natural history of disease process.
Therefore, I would not rush to disagree with the findings of the first doctor. I think you should obtain copies of  the echocardiogram and the ventriculogram showing weakening of the heart muscle and have them compared your recent normal study. This condition is serious and you should consider being evaluated at a large university based medical center for an expert opinion.

Thanks for your question,


CCF-MD-KE
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