EF numbers

[reavil]

1st, a little background. I had a heart attack in 2002 at age 47. They 1st tried stents, but could only get two in, so I also had triple bypass surgery. I went through rehab, and went back to work in three months, and have done pretty good until the last year.And by the way, I am a vet, and get a good part of my medical help through the VA Health system.

I developed diabetes (in check with the pill), and suddenly gained weight, which I don't seem to be able to lose. Then last October, I suddenly started retaining water,swelling in the arms and legs. I went to the ER, and was given an ECHO and a sleep apnea test.

The apnea test did not show any appreciable apnea, but several times during the night, my breathing became labored, and O2 level dropped dramatically.

Then I got the results of the ECHO. the ejection fraction was 35-40%, and the mid to distal septum is severley hypokinetic to akinetic.

Can anyone tell me exactly what this means?

[kenkeith]

Your EF appears to be high enough to not experience congested heart failure, but your symptoms indicate chf. Your weight gain may have added a burden to the heart.  This condition happens when more blood is received from the lungs than the heart is able to pump into circulation.  The blood backs up into the lungs and fluids leak into the tissues (edema) and 02 drops and there is breathing and dry coughing episodes, etc.  I had chf, hypokinesis, enlarged left ventricle, etc. 6 years ago.

To have hypokinesis (impaired movement) of the septum is not as serious as hypokinesis of the contracting walls of the heart.  The septum is the wall that separates the chambers and normally does not have much movement, and that can explain why your EF is low but not in the heart failure range.  Heart failure range is below 29%, mine was 13 to 29%.

With medication my heart has returned to normal size as well as my EF is 59%. To explain there is a phenonomon medically termed "hibernating myocardium."  This is a state of contractile dysfunction during chronic ischemia...lack of adequate blood flow to the heart cells.  When the blood flow was restored with a stent and medication, the contractility improved gradually.

[erijon]

Your EF% is low at 40%, normal is 50-75%. This is the efficiency of your heart, in your case your heart is pumping 40% of the amount of blood in your left ventricle with each beat. Hypokinetic means that some areas of your heart muscle have diminished movement and are not contracting normally. Akinetic means areas of no movement at all. Your have been diagnosed some where between hypokinetic to akinetic meaning impaired movement of no movement. The recommended grading scale for assessing segmental wall motion is as follows: 1 = normal, 2 = mildly hypokinetic, 3 = severely hypokinetic, 4 = akinetic, 5 = dyskinetic. This could be the result of muscle damage due to your heart attack. Some of this may also be due to cells that are "stunned" that may become normal again with treatment.

Have you discussed this with your cardiologist yet?

I hope this helps,

Jon