Is it time to see a heart failure specialist?

[babygirlyoyo2002]

I have heart failure, my EF is 30%, I take 2 diuretics, an ACE inhibitor and a beta-blocker I am always SOB after short walks. My resting heart rate (HR) is over 100 but my blood pressure today was 94/62 (which is my usual) and all of the doctors (cardiologist, endocrinologist (I'm a diabetic also) and electrophysiologist) say the HR issue is because of my heart failure. I am wondering is it time to go to a heart failure specialist?

[nextofkin]

YES, absolutely! Even though you are taking the right medications, the exact combinations and doses can be of crucial importance. My husband was close to death after seeing a cardiologist who kept giving him the same doses of the same ACE inhibitors and betablockers until finally he came to a competent physician who adapted his drug regimen to his condition. He dramatically, but at that time he had most likely already lost decades of his life. Don't wait! The drugs can only stabilize (or possibly bring up the EF a little bit), not cure or reverse the decline in ejection fraction.

[kenkeith]

For some insight regarding to your doctor's comment higher heart rate with lower than normal EF.  Cardiac output is the amount of blood pumped into the system within a one minute interval.  The volume within the minute interval is heart rate for the minute plus the volume with each heartbeat. When the volume is reduced due to lower than normal EF, the heart pumps faster to maintain the same cardiac output...lower EF faster heart rate, higher EF reduced heart rate for the same cardiac output.

Heart failure occurs when the heart cannot normally meet the system's demand for oxygenated blood and heart failure mode recognized by insurance underwriters is an EF below 30%. Your cardiovascular system dysfunction should be treated and monitored by a cardiologist.  You are on medication for ischemia (low oxygen level to heart cells) and that is almost always due to occlusions (partial blockage) of heart vessels.  The ACE inhibitor and beta blocker medication is to widen the diameter of the vessels to increase blood flow and beta blocker SHOULD  reduce your heart rate.  I have been on that medication going on 7 years, and I was in heart failure with an EF below 30%...I was hospitailzed with congested heart failure.  My enlarged heart and EF is now normal with the medication.

You should see a cardiologist and have an echocardiogram to determine if your heart's left ventricle is enlarged, heart wall movement impairment, structual impairment of valves, etc. Thanks for sharing and if you have any further questions or comments you are welcome to respond.  Take care,

Ken

[CCF HeartMD5]

You have a low ejection fraction and it sounds as if you are having symptoms of shortness of breath with minimal exertion. Additionally, it sounds as if you are on the correct medicines: an ACE inhibitor, a beta blocker, spironalactone, and diuretics. It may be very reasonable to see a heart failure specialist since you are still symptomatic.

There are several things to consider in managing your heart failure. It would also be helpful to know what is the underlying cause of your heart failure. Also, the doses of your various medications may have to be adjusted. Your heart rate may be able to be lower, but it is hard to say without a more detailed examination.  You may be carrying to much fluid and may be congested. There is also the possibilty that you may benefit from the additional medications.

A cardiologist who specializes in the management of heart failure would be able to address the above issues. Good luck.