Low ejection fraction/Cardiomyopathy

Hi,

I'm a 27 year old male, with no prior history of health problems.  A few months ago, I began feeling "under the weather", and wound up in the ER twice in 3 days.  I went to a few specialists, had a brain MRI, which were negative.  More recently I saw a cardiologist who ordered a stress test, holter, echo, and finally cardiac MRI.  The stress test, holter, and EKG seemed fine.  However, the echo showed a low ejection fraction, confirmed by the MRI.  The fraction in 41%, but the report showed normal size of the heart and chambers, and no thickening of the walls.  My cardiologist says this may have been caused by a virus, and put me on an ultra low dose of Coreg (3.125mg 2x/day).  I am obviously very concerned about this because of my age.  And was wondering if there are any other explanations?  And will my heart return to normal strength possibly?  Any advice/thoughts would be greatly appreciated.    

[kenkeith]

Does the echo show hypokinesis (impaired heart wall movement)?  Ruling out cardiomyopathy, apparently done, then heart muscle damage has to be the result of viral, drugs, medication, alcohol, etc.  

Coreg is usually treatment to stablize heart rate?

[ceeks55]

Thanks for the reply, I really appreciate it.  Yes, the cardiac MRI showed "mild hypokinesis, with unknown etiology".  I can tell you that I don't take drugs, any regular meds or drink much, so I guess virus fits?  I'm sorry, but what part rules out cardiomyopathy?  If that is the case, how damaging can this virus be, and is there anything that I can do about it?  I know this is naive, but my main concern is, can I be physically where I was before this happened.  Any advise you give would be greatly appreciated and put my mind at ease.

My Dr. put me on Coreg I think as a precaution until I meet with an Electrophysiologist.

[sciman]

I had a similar diagnosis 1.5 years ago. Everything looking normal except ejection fraction of 46%. They started me out on the low dose of coreg too. Another explanation could be genetic, but your age would probably rule that out unless other family members had issues early on. As far as recovery goes, my cardiologist said about 1/3 get better, 1/3 stay the same and 1/3 get worse. You're young so perhaps your more likely to improve. I've stayed the same since being diagnosed. I was very active before my diagnosis and since then I've remained active but changed what I do. I eliminated heavy weight lifting and competitive sports. I switched from mountain biking to road biking. I haven't told my cardiologist about the whitewater kayaking. Can't give that up yet - ha.

[banglamom]

First of all... I'm SO sorry.  I know it is terrifying.  I was 25 when I had viral myocarditis and I am afraid it did change my life.  At the same time, let me tell you.. I'm 41 now and I still work almost full time.  sciman's stats are correct but there is a lot wrapped up in" better, same, worse".  What really baffles me is how some people (and you are not the first I heard of) can have myocarditis and not know.  I struggled with an serious unignorable problem for 6 months.  My heart pounded away at a minimum rate of 180 for the whole time.   Now, when I see people come in to the hospital with a diagnosis of viral myocarditis, I have WAY too much empathy.


COREG  is a type of medicine called a beta-blocker. It is approved by the Food and Drug Administration (FDA) to treat mild, moderate, or severe heart failure. COREG helps to lower the heart rate and makes the heart pump better. COREG  is proven to help people with heart failure live longer and stay out of the hospital.

That is from the coreg website.  I'll tell you, it is the only drug that stands apart from all the other beta-blockers with a proven statistically to increase longevity.  There is somehow more to it than just a beta-blocker.  Nearly all patients with any degree of heart failure are put on it becuase it does seem to "make people live longer and keep them out of the hospital".  Those actually aren't empty words.  Also ACE inhibitors show some potential for cardiac "remodeling".  You may end up being put on that too.

So, there is a chance it will get better and probably with you taking those meds.  Don't be in a hurry to get off them.  If it stays the same, just know how much worse  it can be and be thankful for no further decline.  Don't go too far down the road of "how bad it can be" yet.  Let them figure out where you are and a plan.  You will paralyze yourself with "what-ifs".  Come here for answers from people who have actually been down these roads already.   When your dr tells you what med, what test, what plan he has... someone here can explain how it plays out in real life... and lots of support.  Take more info when you need it.  One piece at a time.

Don't borrow trouble from tomorrow, today has enough of it's own to get through.  (Not just a good idea, it's biblical.)  Blessings to you.  I will lift you up in prayer.

[Scott927]

I can relate to a lot of what you are going through.  I recently went in to my doc because I felt a slight flutter in my left chest while sleeping on my left side.  Normally, I wouldn't have gone to the doc, but I have a family to worry about so I thought I should.  He said (according to ekg) that I had PVC's which are not unusual (most people have them at some time).  My heart rate was normal as was my cholesterol.  I had a stroke screening prevention at work that also came back normal.  The only thing abnormal was a high red count.  My doc sent me to an oncologist for high red count who in turn sent me to a cardiologist just to make sure there wasn't an issue with my heart.  Turns our my red count is high but not to the point of requiring any intervention other than a daily low does aspirin due to possible polycythemia vera which is a disease that causes an over production of red cells but is treatable, but my echo showed that I have an EF of 20-30%.   I was floored.  Up until a few years ago I ran 20-25 miles per week.  I don't smoke, am a social drinker, and other than putting on about 50 pounds since I got married 7 years ago (about the time I stopped running) I am in good health. I've never had any major health issues until now. I'm still active and had been stair walking to take off the weight at the time of my diagnosis.  Other than feeling a little out of shape, I was fine (no shortness of breath or undue fatigue).  I go back for more tests Tuesday, so I am hoping and parying that it is not as bad as the echo originally showed.  I really don't want to go under the knife, so if there is a problem I hope it can be treated with meds and lifestyle changes.  Obviously I have been talking to anyone and everyone trying to get some reassurance and advice.  I think if anything, you need to take banglamom's advice; don't worry too much about the "what-if's."  Personally, my feelings are that if there is a problem, I'm glad they caught it before I had an MI.  There are some great treatments out there that show promise.  Since your EF isn't that low (compared to mine any way) then perhaps you caught it before your heart was damaged too badly.  Frankly, I would love to have an EF of 41.  Things can always be worse.  I know that's not much help.  I still worry about mine and I'm dreading my appointment Tuesday because I'm afraid the results might be bad. On the other hand, I'm glad that I caught it when I did.  I hope your prognosis is good.  And baglamom, I'd appreciate it if you would put on your prayer list as well.

[banglamom]

I have an appt today as well to see where mine has gone of late.  I always get terrified going to the cardiologist.  They never say... everything is fine... just see me if you need me..  It's always, well.... this is ok, maybe we can try_____.  I've been fretting for a couple days but soon it will be over.  Chances are, I will just have appts for all the other tests they want to schedule.  I'm waiting for the magic cure to come along.  Maybe today.  Sorry I'm so disjointed I can barley think today.

[michigankat]

i was dignosed with mild cardiomyopathy with enlargment of left ventricular with regergitaion,with 40% ejection fraction,i just wonder how serouse this is or can get

[Happysnax]

Hello, I just wanted to let you know that I have cardiomyopathy caused by a 'virus' while I was on holiday in the usa,I was 18 at the time and my word I was freaked out I had 6% enjection fraction and top of the trantsplant list.I had so many drugs hooked up to me my room was a pharmacy, from what I remember I had enalipril heprin milranone asprin degoxin morphine dopamine plus a few more that I can't quite remember. I was also in a wheel chair for a    couple of years until one day I had enough of  living with it, I had to regain my life it was the  best thing I could gave ever done, I came off of   enalipril 2 years ago now. Prior to this attack I   was a heathy,active in every way. Could I have   avoided  it? I very much doubt. This was 13  years ago I  was at deaths door ! But as time  went on I got  better and better, how I do not  know. I think your state of Mind really helps your future In every way,what I'm trying to say to people in this situation is don't right yourself off just yet ! Listen to your body and yourself a good. Cardiolagist . Praise dr conti without him  I would not be writting this text.
Stay well  happysnax

[Mom2four85]

oh wow, sounds like you've been through the ringer and back - an ef of 6%

Did you have any problems with withdrawl (withdrawal) for your meds? That is amazing and glad you posted - what did your ef improve to?

I agree about the mind - I've said this and posted so many times....the mind is a very powerful tool, use it wisely [which I have to remind myself of often]

[oneyejack43]

Hi everyone I have just been recently diagnosed with A-fib and low ejection fraction 3 months ago. My ef is 25%. I am 49yrs. old. My heart cath came back normal about 10% blockage.Except for Low ejection fraction. I have the symptoms of short of breath which is often,also light headedness not all the time depends on what I'm doing,also I noticed low blood pressure,too. How can some people have symptoms and some people don't?

[kenkeith]

It is estimated about 26% of the heart disorder populatioin do not know they have an EF below 29% (heart failure range). Sometimes a patients with a lower EF feel better than a patient within the normal range of 55 to 75%. Some individuals compensate well others don't.

If your system compensates well,  that will reduce the demand for oxygenated blood and a low cardiac output will not stress the heart and produce symptoms.  If your system, for instance high blood pressure, the heart will work harder and the result can be an increase in symptoms.  Between these two extreme conditions there can be a variation with symptoms.  If you are on medication, that can be a factor as well.  

[oneyejack43]

Thank you..They have me on a high dose of coreg 25mg 2x daily along with verapimil,lisinopril,lasix,and other meds for diabeties.I have good days and bad days..I also am dealing with A-fib..I have had A-fib before..And I am dealing with sleep apnea..I guess when it rains it pours..My doctors are mainly working on my longevity of life for now..Getting heart back in sinus rythmn with a cardio-version..The first episode with Afib in 2005 it took several attempts for it to take..They have told me there is no fixing what I have..short of a heart transplant..

[Franklin60]

Hi, I am 60. Female. I had a heart attack and went into respitory failure on May 10th of this year. I will be seeing my Dr. Wednesday to find out my ejection fraction. Hoping for a good number. Hoping the heart attack didn't do any damage. I also have COPD. Chronic Obstructive Pulmonary Disease. I am now on oxygen 24/7. Wasn't on it before even with the COPD that I have had since 2000. Does anyone have any comments or opinions? Any would be suggested. Thanks , Pam

[kenkeith]

My first cardiologist stated I needed a heart transplant little more than 6 years ago, and today and since my heart event I have not had any days feeling ill and the heart is normal size and pumping effectively.  It may be a mistake for your doctor to make that comment.  Take care of the A-fib to reduce the probability of arrhythmia, and maintain a positive attitude and you masy do very well.

[kenkeith]

If the heart is not pumping effectively, there will be a reduction of blood oxygen, and that will exacerbate the COPD symptoms.  You are correct, the EF percentage will provide some information for a prognosis and the appropriate treatment.  Hope the numbers are good for you.  Take care.  

[Franklin60]

Thank You.

[optimistic1963]

I read your post and hope you are betting progressively better.  I was diagnosed in May with 5% ejection fraction, dilated cardiomyopathy, non-eschemic.  I did not feel sick until about 3 weeks before I went to the ER with shortness of breath, swollen abdoman and swollen ankles.  Doctors said they could not believe I was still up and functioning.  On all kinds of meds now with an external defibrilator.  Go to cardiologist next week for echo.  Wish me luck.  Thanks

[swt_amy]

I am 43 years old female, I am very scare and freaking out. I was having little short of breath, still able to take long walks, no symptoms.  Couple weeks ago, I had an ekg done just for the hack of it since I am an RN and I work in the ER.  My EKG was abnormal with wide QRS complex.  My heart rate had been for the last couple of years beat like a chicken of 87,88 so I never took concern,  however, I was advised by my ER doctor to see a cardiologist for more testing.  My Echo came back with Ejection fraction of 20%  I am still in denial,  because I have always been in good health, I don't do drugs, I don't drink.  My cardiologist states unknown etiology at this point, might be brought on by a viral infection while ago.  Yesterday, he put me on coreg 10mg daily, and start Diovan in the next few days, my bp is always been normal.  I only weight 104 lbs.  I wonder how could this happen?  can some one give me some hope?  I am scare!! I don't want to be in CHF.  Help.. I am crying and have been since diagnosed.

[swt_amy]

Hi everyone
I hope you all still get on this blog, because I need you.  I had my angiogram yesterday.  It's normal, heart size normal.  Ejection fraction clearly is 20%  with left ventricular weakness. I am on coreg, will start diovan tomorrow.  My bp is 112/80. heart rate around 78. which my doctor concerns and want to bring it up to the 80s.  I really hope to hear from you all.  

[Irishking23]

Hello
I went through a nuclear scan of my heart and also a chemical stress test hooked up to an electrocardiogram or EKG last week.   The cardiologist called this afternoon with the test results.

He said my heart’s pumping ability is down noticeably from last year.  Last year it had 35 to 40 ejection fraction (that is the heart’s ability to squeeze or pump) and now it is down to only a 27 ejection fraction.  He wants to take action now to try to do something rather than let it go worse.  First, he wants me to immediately increase my beta blocker, METOPROLOL to 1 ½ pills a day and he also wants to add another heart medication something like Adacto (sp?).  He also wants to schedule a heart cath/angiogram and do some stenting of clogged coronary arteries to try to increase blood flow.   On a heart cath about 1 1/2 years ago, I had one diagonal artery occluded about 80% and nothing more severe than that.


He also talked about maybe adding a pacemaker and a defibrillator.


They are scheduling me for a heart cath now where they will go into my coronary arteries and try to stent them.

The cardiologist said it is no wonder I have been so short of breath because of my weak pumping heart.


I am just wondering if stenting some occluded coronary arteries will increase my heart's pumping ability.    Has anyone out there had any success?

Irishking

[sahil444]

hi
i am sahil. i am 21 years old and i have been diagnosed with lvef 18% when i was 18 years old and it reached to 30% at 19. i am currently 21 yrs old and there had been no improvement in last 2 years. i feel totaly fine with no problems. what are the chances n hopes?

[kingzworld]

Well im Currenlty 33, with cardiomyopathy caused by genetic along with ejection fraction of 30%. with less then 8% blockage

I was diagnose at the age of 25 with cardiomyopathy with an unknow cause ad a EF of 45%  I had less then 4% blockage.  I was put on corag like most ppl with trice dalily, I level out at an EF of 42% for about 4 years, the last 3 years have seen massive uncrollable falling at EF of 30% two months ago and dropping. currently working on getting a diffibulator installed in the next two - three months.

Since my massive falling from EF of 42% to 30% I have started passing out,  my heart at reast wile sitting down would race at over 150rpm then drop down to under 50rpm, at that point I would start to feel extreamly tired and if the drop was even lower I would loose it completely and pass out,  I could wake up 5min to an hour later with my boddy pumping. I can feel blood repumping to my system.

has anyone else here have had this problem of passing out.  its been in the last two years...  at first I thought I might have sleep acnem and even the test showed i did and got a machine, but then it start happing with hours of me waking up or it would go two or three times a day.

after working for a company for the last 10+ years, I'm being fired for lack of work do to passing out at work. so im screwed now.  but I have to keep moving and I can not stop, I haver a 3 month old, 16month old, and a two year old I have to support...  tiss life looks like no reitrement for me LOL

KINGZ

[disneynut2871]

I know its over two years ago since you posted, but I just seen this.  I had found out too about the same time about my low ejf of 35 and now 30, and have 30000 pvcs a day.  I was just like you then, cried continuously and had anxiety issues.  I have talked with several people and feel better...because you can live a long life with this issue.  Mine was caused by a virus.  I am 41 years old now.  I am taking Coreg 18 mg a day and also lisonopril. I just keep hoping it will get better.  I do not really feel any symptoms except get out of breath with exercise, steps or a lot of walking.  How are you doing now?

Rebecca B in PA

[karenjoyhope]

Hi there. I am a 33 year old female who was diagnosed with cardiac sarcoidosis. At that time my ef was quite good at 49%. My resting pulse is at 100bp. Blood pressure eratic. I have been on no meds since March. My Prof just started me on 12mg of Carloc daily. Problem is that I'm also an asthmatic and every med I have been prescribed has cause adverse side effects. I am a mother of 3, eldest being 13 yrs, 10 yrs and 11months. Needless to say, I'm terrified and don't know what any of this means in the long run. I have responded to no meds. Sarcoidosis is in my family. ALl articles relating to cardiac sarcoidosis are bleak at best. Anyone out there with advise? Karen from Cape Town, South Africa.

[pete727]

Hi there,
As your Dr. to consider on you Metoprolol succinate (betablocker with the most data bihind it ) and an ACE inhibitor(Lisinopril, prevent remodeling of the wall of the heart ) both of these meds decrease mortality in HF patients.
Best of luck, Pharm D student.

[smshelby2002]

My daughter just got out of the hospital.  She's 35 and has had a routine gallbladder done but during the surgery she went into shock, her BP dropped along with her sats.  They first thought that she had a reaction to one of the anesthetics but had an echo done which revealed a 25% EF with severe cardiomyopathy.  The cardiologist said that he's never seen this before in someone so young.  She was placed on Lisinopril and Metoprolol along with lasix to get the fluid off her heart and lungs.  I've been googling trying to find out the why this has happened to someone so young and generally healthy.  We believe that she didn't really even need the gallbladder removed now since all of her recent symptoms are parallel to heart failure.  The Dr mentioned that it may be related to her pregnancies (she's had 4) but I don't find much supporting documentation.  Anyone??

[bpress500]

Hi, I am a 55 year old male, 5' - 8", 165 lbs who thought I was in pretty good shape for my age. I work out (Heavy Weights), play softball and in general just very active. I don't smoke, drink or do drugs. However recently (last few weeks) I began to feel light headed and tired from doing small task. Didn't notice any light headed feeling when really exerting myself.
My son in law who is a dentist talked me into going to the emergency room because he checked my pulse rate and it was 30. (This turned out due to PCVs.)
To make a long story short I went into ventricular tachycardia in the ER at the hospital.
An ultra sound revealed that my EF was 35%, after getting me stable, two days later they performed a heart cath which showed no blockage, a slightly enlarged aorta and some thinning of another part of my heart (sorry can't remember what part) Results after the heart cath showed that my EF was up to 55% in just two days.
The doctor (38 years as cardiovascular specialist) so he's seen a lot could not explain it. I had a lot of people praying for me, so I we attribute it to prayer and praise the Lord for the 55% EF.
I had the flu about 3 months ago, so they are saying that its virual, because everything else looks mostly normal. I am currently on Amiodarone, Lisinopril, and a baby aspirin.
I was out of town camping when this happened, am home now and will see my new heart doctor tomorrow.
Like most of you I am not sure what the future holds for me just gotta put it in the Lords hands and try not to worry.