"Pump" Function

I just found out that I have gone from 50/55% heart (pump) function a year ago, to 40/45% pump function today.  That is a 10% decrease.  I am a 57 year old white female, I work out, eat right and weigh in at 128 pounds.  What is this problem called and what causes this?   A year ago the doctor DID NOT tell me about the reduced heart function, he  only told me that I have PVC's and put me on 50mg of Toprol once a day.  I admit that I failed to take the medication after about 4 months.  Could that be the reason my heart function decreased? Also, because the doctor failed to inform me about my heart pump function being at 50/55% a year ago, and he did not let me know about the test results today, (I had to call back and talk to the nurse after I left the doctor's office to get the results) should I change doctors? What if anything can I do to improve my heat pump function? Thanking you in advance for your help....

[CCF HeartMD6]

Unfortunately, it is impossible to make an accurate/correct diagnosis over the internet. However, there are a number of different causes that can cause an ejection fraction to be reduced and/or decline over time.  Your history of PVC's could certainly be a cause for this reduction, especially if there is a large burden (>24% by some studies). If medications have been previously prescribed for this condition, it is important that you follow the recommendations by your physician.  If there are further questions about your echocardiography findings, you should address them with the prescribing doctor/cardiologist.  A second-opinion is always an alternative if you feel like you would like evaluation from another physician.