What is reasonable activity level for 45 EF?

In 1998, I went to the emergency and found out that I was in Congestive Heart Failure with an ejection fraction of 10-15%.  I was temporarily put on a heart transplant list while i tried medication.  The multiple prescriptions helped me to the point that I have now leveled off at about 44-45% EF (with no heart transplant).  What would a normal activity level be for this level of EF?  Also, once you have had Congestive Heart Failure, do you always have it?  I also have fibromyalgia which causes fatigue.  I am trying to figure out how much of my fatigue comes from the cardiomyopathy as opposed to the fibromyalgia.  Side-effects from some of my medications also add to the fatigue.  I am currently 62 and applying for disability.  My pain and fatigue make it impossible for me to work.
Thanks,
Linda Keeler

[Encephalomalcia]

The fatigue could also be caused by your heart medications as that is a side effect.  It is important to stay on the medications even if they do make you tired.  The medications have greatly helped your heart.  When CHF is getting worse, the person can cough up clear or white mucus.  Has that happened to you yet?  Make sure to weigh yourself each day in the morning to make sure that you are not gaining a pound a day, which would mean water retention.  The main thing is to keep the water off.  Having a healthy diet of fruit, vegetables, brown rice, salmon and avoiding red meat and processed foods and salt is the best for helping your heart.  It is amazing that the EF went up so much.  The cardiomyopathy can get better, can get worse, or can stay the same.  With an EF of 45%, the activity level would usually be low.  Do not push yourself, but try to get in some exercise.  Walking usually makes people with cardiomyopathy feel better, just don't push yourself.  Listen to your body and do what your body tells you.  Rest when you feel like resting.

[sukumar794]

After the AWMI episode back in October 2007, the Echocardiogram revealed an EF of just 26%.But later with strict adherence to the prescribed medications and schedule of exercises program of mainly walking, the EF has gone a little bit higher of 30%.I am quite aware that I stand a poor chance for tough jobs requiring much physical strength.Better still can I hope to continue living in a healthy manner and of course free of worries about longevity and quality of life?Please be frank in your outlook.

[kenkeith]

CHF is a condition where the heart does not effectively pump out all the blood received from the lungs, and blood and fluids backup and leak into the lung tissues.  One does not always have CHF, but the underlying cause for CHF is the determining factor.

Your weak contractions (EF below 50) can be due to heart muscle damage or cardiomyopathy (dilatation of the left ventricle).  If there is heart muscle damage due to heart attack, viral disease, etc. the CHF may come and go depending on how well your system compensates for activities involved.  But if  LV ventricle enlargement is the underlying cause (my situation...had an EF 13-29% before treatment), treatment can reduce the heart's workload and LV enlargement can reverse size and EF return to normal (my EF is 59%).  I beleive from what you wrote that may be your situation.  Heart muscle damage from heart attack, etc. may limit EF improvement if any.

A  disability claim, from my understanding (state comp and insurance policies will differ) requires heart failure to be represent by an EF below 29% with treatment.

To determine eligibility, there may be a stress test.   A stress test will gradually increase level of exercise (stress) untill there is an indication you have reached your tolerance level as measured and monitored by a doctor or if pain or fatigue is present and patient wants to stop...I was unable to complete the test and it was discontinued after 7 minutes.

I tolerate medication well and do not have any other issues other than cardiovascular  so my situation may not be a good comparison.