Increasing Ejection fraction after heart attack

Question

My dad had a heart attack less then a week ago.  He has no health history, very healthy.  His ejection fraction was 20% during and right after the attack.  They placed a stent, he also had a clot that was removed.  He is taking coumadin, water pill, lisinopril, coreg, plavix, asprin and lipid lowering agent.  How can he increase his ejection fracture and how much activity is he allow to do this early?  How about traveling 2 hours by car?

Amrit19 · Answer

Hi Sir, My father met with MI on 28-11-13 and its more than 6 month he is not getting over breathshortness. Always complaining about palpitation and loosing his mental balance.His EF is 30% now currently have swellon stomach and legs.He is frustrated with hospitilization and don't want to be treated (repeated senior) Can you please help us out how your treatment was proceed, cause the medicine you have written are the same given to him. He stopped all medicine except blood thinner and got swelling. Please help us with your kind suggestions.

Kindest Regards,

Kindest Regards,

ed34 · Answer

I think we would require further information to make comments. 
1. Where are the blockages and how severe are they?
2. Does he have any damaged heart muscle, and if so, what percentage?

Certainly with such a low EF, he should have an implanted ICD unit. This is because his heart is at high risk of rhythm problems and sudden cardiac arrest. This unit will rectify a faulty rhythm and shock the heart if necessary.
He should also be on a transplant list if the heart cannot be improved.

prachi283 · Answer

my father is a heart patient , last year gone through a bypas surgery, but his heart didnt recoverd , hi s ef was 36 % last year n detoriate to 20 % within a year , according to his echo report his , ef is only 20 % , according to dr , thr is no further treatment for him , saw EECp therpy to increase eF , can plz suggest me is thr any ayurvedic treatment through which we can increase his EF......plz bcz he is just 54..suggest me sum ayurvedic clininc

prachi283 · Answer

my father is a heart patient , last year gone through a bypas surgery, but his heart didnt recoverd , hi s ef was 36 % last year n detoriate to 20 % within a year , according to his echo report his , ef is only 20 % , according to dr , thr is no further treatment for him , saw EECp therpy to increase eF , can plz suggest me is thr any ayurvedic treatment through which we can increase his EF......plz bcz he is just 24

kenkeith · Answer

A little more than 5 years ago I compromised my respiratory system by not wearing a mask and inhaled dust working on a home project. I developed a dry cough at night lying down, some shortness of breath and a fast heart rate...no chest pain. I was admitted to ER...chest X-ray showed an enlarged left ventricle, echo revealed impaired heart wall movement and a EF29%.  A cath showed EF13%!? and a 98% RCA was stented, circumflex 72% blocked and not stented, and the LAD is/was 100% blocked and apparently collateral vessels supply an otherwise blood depleted area normally supplied by LAD.

I was in ER for about 3 days to stabilize the pulomonary edema condition (correct the oxygen to carbon dioxide ratio) .  Age was the beginning of the 7th decade, faster than normal heart rate, blood pressure close to normal (not an issue), mitral valve regurgitation, enlarged left ventricle.

I tolerate the medications well: ACE inhibitor (lisinopril) to dilate vessels, beta blocker (Coreg) to stabilize heart rate and dilate vessels as well, furosemode reduce fluids for a few months after ER, plavix and aspirin to help prevent clots (after a year plavix was discontinued and I take an aspirin a day currently), digoxin to increase heart pumping strength (discontinued). I currently take isosorbide before working out 3 times a week to prevent angina, ACE inhibitort, beta blocker, aspirin and have no symptoms.    

If you have any further questions feel free to ask.

dougbaby08 · Answer

So was your EF 13% to 29% when you had the heart event?  Also, how old were you when you had the heart attack?  Did you take coumadin and if so for how long? Also, my dad is on a beta blocker and is having a hard time with it (he already has low blood pressure) did you as well?  Did you have blockage?  Sorry for all the questions but I have told my dad about your wonderful outcome and he and my family have a lot of questions. Any information will be very much appreciated.  Thank you for the time in answering our questions.

kenkeith · Answer

The EF was 13 o 29% during heart event.  Test 6 months ago indicates the EF is 59%.  Reducing the heart's afterload (ACE inhibitor and beta blocker) reduced the left ventricle size and as a consequence the EF returned to normal.  The increased LV size was believd to be the cause of mitral valve regurgitation, but the return to normal LV dimension did not improve mitral valve regurgitation.

dougbaby08 · Answer

Thank you for your very encouraging email.  That is great that your EF is back to normal.  How much was your EF at the time of your heart attack and how much is it now?  Also, what have you done to increase it?

kenkeith · Answer

Sometime the heart cells are not necrotic, but have been stunned by lack of oxygenated blood.  Intervention (stent, bypass) can return the cells to normal functionality and increase EF.  

Also, the heart (left ventricle) can be enlarged from overwork, and that condition can reduce EF.  Medication can/will reduce the heart's workload and reverse remodeling and as a consequence EF may return normal...five years ago my condition was almost identical to your dad's situation and with medication the left ventricle and EF are currently normal.

If there is heart cell necrosis and depending on the severity, the EF may not return to normal.
After a stent implant an individual can return to normal activities within a few days.  There should have been written instructions given after the procedure.