EJECTON FRACTION

[phil]

I am a 47 year old male. I had a heart attack and quadruple bypass surgery 3 1/2 months ago (same day emergency syurgery). I basically was in fairly good shape prior to this attack other than the occluded artiies. I have just had a MUGA Scan ofmy heart and a stress test.The stress test (according to my doctor, shows i have a good capacity for exercise. However the MUGA scan results were not so good.
My doctor has told me that my ejection fraction the day of the surgery was 25, and now is about 30-35. I am currently taking 50mg of Toprol daily, and he wants to put me on altase. My pharmacist tells me this drug is usually prescribed for heart failure.So, my questions are, does/can your ejection fraction improve over time from the surgery and or exercise? Does a low ejection fraction make me suseptible for another heart attack? Does/will this low fraction shorten ones life span?

Thank you for your help.

[CCF CARDIO MD - DLB]

Cordarone, or amiodarone, is a useful medication to treat arrhythmia. We use a lot of it here. It is safe and reasonable well-tolerated at low doses. There are potential side effects with long-term use (really at higher doses). These include thyroid disease, lung problems, and some eye disorders. There are tests to monitor for the development of these conditions that your doctor is probably aware of. The management of your condition is a little unusual though. Most of the time, with three severe blockages and a weak heart, surgery is still recommended.

[Del Rothmann]

I was diagnosed as having congestive heart failure in January of 1994.  The diagnosis was cardiomyapathy and my heart efficiency was about 18 percent. I reportedly had three arterial blockages of about 50 to 85 percent.  I was told to lose a hundred pounds and bypass surgery would be performed. To this date neither has occurred.  I had a relapse of heart failure in October of 97.  The blockages remained consistant from the first angiogram, however, my heartbeat was extremely erratic and it was indicated that I was a candidate for "instant death".  I took a stress test on the treadmill and apparently did better than the cardiologist expected, so he did an EPS study on me and prescribed cordarone.  The cordarone has helped me and supposedly my heart is functioning at or about 30-35 efficiency. I have never experienced angina for which I am greatful,however I still wonder about the blockages and cordarone.  What is the best information about cordarone.  What are some of it's potential side effects.  Thank you!

[robert k. hartenstine]

cardiomyopathy---ejection fraction 15 to 18 percent...now on coreg, vasatec, coumidin, digoxin plus diuretic when needed. Dr. Fred Bove, MD- Temple University Hospital attending Physician..Does not want to put me on transplant standby list..claims I am doing extremely well for my low ejection fraction...I ski at 12000 feet....excercise daily (cardio plus machines and hand weights) limit sodium, am very active...

[CCF CARDIO MD - DLB]

Your cardiologist is well-known and well-respected. I agree with him. It would not make sense to perform a transplant, with all its potential risks, for someone who has good exercise capacity.

[CCF CARDIO MD - DLB]

The Altace is a good idea; it can help improve the ejection fraction. Bypass surgery can help, but would most likely have already done so by now. Exercise is important, not only in strengthening the heart, but in improving the body's ability to compensate for a weakened heart. The low ejection fraction does not make you any more susceptible to developing a heart attack from heart artery blockages. However, you are at an increased risk of arrhythmia, including fatal ones, due to the heart attack and low ejection fraction. In a population of patients with a low ejection fraction, this does serve as a marker for increased risk of death; however, this does not necessarily apply to individual patients.