ejection fraction mildly depressed; widened QRS wave.

[kimshan]

I'm a 59 and have episodes of moderate chest pain; borderline HBP (128/78), and more recently an episode of syncope that lasted about 5 seconds; with dyspnea. I wore a holder;  Had Stress test (no ischemia) ECG, dopler for carotids; results are: Holter: VE total: 20160; ECG: NSR 74BPM RBBBwith associated ST-T changes of RBBB; SPECT imaging revealed fixed defect of inferior wall, diaphragmatic attenuation; LV was normal size. Mildly depressed EF of 50% REgional wall mothion normal.  At Peak excercise ECG revealed no significant ST-T changes; Widened QRS wave:  Arrhythmias included Ventricular bigeminy in recovery as well as frequent VPC's in recovery. Excercise tolerance excellent; heart rate response normal, BP normal  Exercise stress test was negative for ischemia.
2d Doppler results:  LV moderately dilated, mild concentric LV hypertrophy noted. Global LV function mildly depressed with estimated EF of 45-50% Mild to moderate mitral regurgitation and mild tricupsid reguritation assoc with mild pulmonary Hypertension. NO pericardial effusion. Blood tests showed D Dimers at 318 (wnl). I am being treated with ATacand and Metoprolol 25mg;  I still from time to time become a bit lightheaded; wondering if I'm being medicated properly????  Should I be doing anything else? Should I excercise? Would this help EF?  I was once asked if I had a Myocardial infarction after an er visit that turned out to be GI distress (the ER MD read the ECG and asked...)  Apparently I have an abnormal heartbeat..sometimes I feel it flutter or racing a bit..not often...????

[kimshan]

Thank you...I will

[kimshan]

Hi Thanks for the response. No ischemia, my LV is slightly enlargened and has only gotten very slightly larger in 10 years since first testing..Excercise I know is now on the agenda..WAsnt an issue as a kid..I played ball alot, etc..been to sedentary for too long! Thanks.

[Flycaster305]

I think that the ejection fraction is a measure that can change, almost day by day, and also think where the heart weakness is centered is a consideration.  I've had an enlarged left atria for years with about a 40% EF and walked three miles a day at military time until recently when it dropped significantly.
I'd be encouraged by words like Mild, Trivial, Moderate.  Most people, I believe, have trivial and mild heart issues at your age, and it's a wakeup call to exercise, take the drugs you need and eat heart-healthy foods.
If you continue to worry, I suggest you ask your doctor for a BNP blood test, it will tell you if you are starting into Congestive Heart Failure.  

[Paderla Anitha, DNB]

Hi, and understand your predicament. Did you discuss with your treating doctor the reason for the depressed ejection fraction? The ejection fraction is a useful measure of left ventricular performance. The normal range is 63-77% for males and 55-75% for females. It reflects the pumping capacity of the heart. This could be causing your symptoms of syncope and dyspnea. The basic cause for the diminished ejection fraction needs to be treated for the ejection fraction to improve. In your case the depressed left ventricular function, which could be due to the hypertrophy also the arrhythmias could be causing this. Ejection fraction can be improved by lifestyle changes, medications and procedures, such as the insertion of an implantable defibrillator (ICD) if indicated. Discuss these options with your doctor when you happen to meet him next time. Regards.