L.V.E.F.

  I am a 49 yrs old female diagnosed Adriamycin induced Cardiomyopathy.
  I had fatigue after cancer treatment did not go away. I went through many tests and confirmed Cardiomyopathy with EF 50%, mildly reduced. No enlargement or dialation of heart, edema or CHF. I am on Cozaar, Coreg right now. My last chemotheraphy was almost 2 yrs ago. I am doing well with 52% EF after almost 8 month of treatment. Do I  have CHF? Am I never get recover from it? I do not find datas of toxicity induced adriamycin from anywhere. I like to have a hope if there is any if not I like to settle for the truth of my course of CHF.
  Thank you so much !! I think this forum is the best site I found.
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Dear Kim:
Adriamycin can definitely cause a cardiomyopathy, a weakening of the heart muscle.  This is diagnosed by tests such as echocardiograms, which are ultrasound pictures of the heart.  Cardiologists interpret echocardiograms by looking at them and seeing how well the heart is pumping blood.  They come up with a number, the ejection fraction or EF, that represents what percent of the blood the heart pumps with each beat; normal EF is 55 to 70%.  Thus, 50% is really a very mild degree of impairment.  Moreover, the EF is just a visual estimate; the difference between an EF of 50, 52, or 55% is within the range of measurement error.  Much more important are patient symptoms.  Some patients have an EF of 10% and have no symptoms at all.  Other patients have an EF of 30% and have disabling symptoms of heart failure.  Furthermore, medications can improve both the EF and patient symptoms dramatically.  Thus, the diagnosis of congestive heart failure (CHF) should be made on clinical grounds, not on the basis of a number from a test.  I hope this information is useful.
If you wish to be evaluated here at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a cardiologist who specializes in heart failure at Desk F25.  Information provided in the Heart Forum is for general purposes only.  Specific diagnoses and therapies can only be provided by your doctor.