LV dysfunction

My husband suffered an anterolateral MI.  He currently has mild hypokinesis and akinesis of the left ventricle.  His ejection fraction has improved from 25 to 30% to 35%.  He had a ptca and stent to the mid Lad and a ballon angioplasty of the diagonal where the two bifurcate.  MYquestion is can we expect to see an improvement in the LV dysfuction and if so what kind of time frame can we expect.  He currently takes coreg for the LV dysfucntion and BP.  He experienced some "heart failure" while hospitalized that was resolved with two doses of lasixs and has been asymptomatic since.

[CCF-M.D.-RCJ]

Mamachris,

Thanks for your question.  Sorry to read of your husband's ordeal.

Many patients with an MI have improved LV function at follow-up.  The likelihood of improved function depends on many things: how quickly they received reperfusion therapy (angioplasty, stenting, or thrombolytics), how successful was the reperfusion therapy, how soon after the MI the first echo was obtained, what other medicines the person receives, what other conditions the person has, etc.

If an improvement is seen, it is usually apparent by 6 weeks, although a minority of patients continue to have improvement thereafter.  The history of heart failure while hospitalized implies that the MI was a large one, and thus your husband would be less likely to see continued gains in LV function.

The most important point now is for you and your husband to do everything possible now to prevent further MI's.  Lifestyle changes to discuss with your husband's doctor include smoking cessation, weight reduction, exercise, and establishing a healthy diet.  Some medicines that your husband should discuss with his doctor include aspirin, beta-blockers (like the coreg), ACE-inhibitors, and "statins".  Regular follow-up will be a key point to prevention.

Hope that helps, and good luck.

[rn_sureshkumar]

A related discussion, LV disfunction was started.