LVEF dysfunction

[vikramdawar]

Sir,
    This is in continuation of my query to you on 16/05/07,reply to which was received on 17/05/07.However,there are certain points still to be cleared and advise sought.The age of my sister is 29yrs.She has had 2 deliveries(both caesarian).The last delivery being 1yr4months,i.e 30/01/2006.In nov'06 the echo report showed EF<26%.She took and is still taking the following medicines:VALENT 80,DYTER 20,PANTOCID DSR,LANOXIN.However,in the echo done on 5/05/07 the echo showed EF<15%.Why this reduction,though she now DOES NOT have breathlessness.Is STEM CELL procedure helpful in such cases.Her ARTERYS AND VALVE ARE NORMAL.There is NO BLOCKAGE.She is mentally not prepared for surgery as her children are small,elder daughter 3yrs and younger one 1yr.Can these medicines with time and with necessary precautions such as low intake of liquids and sodium content in food improve her EF value.Is it possible that she can lead her life with these medicines in the long run.Kindly advise.What about STEM CELL procedure.Kindly advise.

[danielles]

When do you reccommend coreg?  I am a 36 year old mother of a 2 and 3 year old.  I have no symptoms. I had some rapid heart rates during my pregnancy, nothing notable,  and had an exit echo done.  This showed an ef of 40%.  A month later I had a nuclear treadmill stress test done- this showed an ef of 53.  I do have a heart rate that goes into the 180's quickly but then stabilizes. I have no other symptoms.  I am extremely nervous about being on any type of meds.  My dr. said he recommends coreg if I were a 55 year old male and that he would see me in 6 months since I may not be done having children.  I am confused about treatment options.  Will losing weight and exercising help the ef?  Am I able to die in a few years?   My mother did die at 30 due to clogged arteries and possible heart shock.  Thank you.

[Brothabill]

Your sister absolutely needs to take Coreg with that Ejection fraction.
And ejection fractions are nebulous. They are truly not calculateable given the errors inherent in the calculations and are best judged by an 'experienced' eye. Hence, two experienced eyes will give two different descriptions.

Less than 15% is like super severe, as in, cant function and nearing unconsciousness, the outcome is very grim as for length of life. It's probably here EF is 15-25%, which may be a more understandable way of explaining it.

I have seen wonders with Carvedilol (coreg) with people with cardiomyopathies. Some, don't but, I just saw someone who lost their EF down to 20%, went on Coreg, was back up to 60% in the normal range. Went off his meds, swelled up with water, his EF in the hospital was back down to 20%. At which point he went back on Coreg with a renewed understanding of how important it was, with his wife's motivation (who is also a patient). And remarkably he returned back to a normal EF.
That is very very rare. People can get their EF back once, but usually not twice.
But there are some miracles with Coreg as far as EF.
When we see EF return with alot of cardiomyopathy people. We just shake our heads and say that's Coreg for you.

[Forum-M.D.-bkj]

vik,

I know this is stressful for you and your family. Young people with severe ventricular dysfunction definitely need to be followed by a heart failure specialist.  

Why this reduction,though she now DOES NOT have breathlessness.

Breathlessness is only one symptom of heart failure. If her EF is truly 15%, she may have curtailed some of her activities to where she doesn't experience symptoms. If she went through a thorough stress and metabolic examination, it would probably be lower then when her heart was functioning normally. However, the fact that she doesn't have symptoms does improve her overall prognosis.

Is STEM CELL procedure helpful in such cases

No. Stem cell therapy is still in the experimental stages. There is no concrete evidence of the therapy at this point.

good luck