Heart size reduction but reduced EF

Posted by Nanci on April 19, 1999 at 15:42:21
My last x-ray and echocardiogram results showed a markedly lower heart size -- not too much above normal -- but a considerably lower ejection fraction -- from the 40s to the 20s. I am still in Class 1. My doctor was unable to explain the reasons for the change. I would be grateful for any input -- feel like I'm on a yo-yo and getting very depressed.

Posted by Bill Raridan on April 19, 1999 at 17:05:01
Hi
I've got the opposite. EF was 35% now 50% , but no size reduction. I'm taking COREG and Lysinopril. HOw's your exercise regimen ? Do you have classical symptoms, chest pain, dizzy, etc ? on exercise. Absolutely Talk to Your Doc beforehand......................
I do 35-45 minutes every day on the treadmill, 2 miles @ 3 mph, 3.5 deg incline. This is 6 months post diagnosis, and it took about 3 months to get this energetic. In addition, 10% weight loss, 2" off waist. Buying treadmill best $700 I ever spent.
This disease *****, but I am optimistic that a combination of diet, exercise, and medications, will make this a livable condition, if not reverse it. I have a 88 year old friend, a retired big time surgeon. I ask how he feels, he says "I woke up this morning, that's a good start". I'm thinking, one day at a time, a little more exercise today than yesterday, tomorrow will take care of itself. Keep Trying, its not the numbers but how you feel.
Posted by CCF CARDIO MD - CRC on April 20, 1999 at 16:23:24
Dear Bill,
Thanks for your input and encouragement.  Many people can do well with heart failure with the proper medication and exercise program.  As you said this should be closely supervised by your doctor.  How long have you been taking the Coreg?
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
Posted by Tony Poole on April 22, 1999 at 13:57:40
I'm in a similar situation, but with as yet unseen results.
I've been on Coreg and Zestril for 14 months now.  First 6 months was at
a considerably lower dose of coreg than I now take.  I've been on 100mg total daily of coreg, 40mg total daily lisinopril for 4 months.  At diagnosis my
EF was 15%.  I'm 32 years old.  I never ever *felt* bad - the only reason I went to the doctor was because I began to notice my heartrate was always fast - 120bpm even at rest.
After 8 months of 25mg total per day coreg, my
EF was unchanged, based on a MUGA.  I then asked for a received a reference for
a second opinion, and was directed to a doctor at UofM.  He upped my Coreg to
100mg per day, and added aldactone.  The additional coreg has very much made a difference in my energy level.  My heart will absolutely not beat fast now, even when it needs to (85-90 at rest, 100 or so otherwise).  In fact, I swear that when I overworked myself a bit too much a couple of times, it slowed.  
I guess my question would be: is there a better than average chance that this
high a coreg dose will give me significantly better benefits than, say, 50mg?
Posted by CCF CARDIO MD - CRC on April 23, 1999 at 11:42:06
Dear Tony,
It is a fine line between too low a dose of Coreg and too high a dose.  To obtain the best medical effect the highest dose tolerated is best.  If however there are side effects at a higher dose than a reduction may be necessary.  I would not make any changes without discussing it with your physician first.  Have you been considered for a heart transplant program?
I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your
physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire
online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the
cardiology staff that can be used to select the physician best suited to address your cardiac problem.