what does my reduced EF indicate?

[LaRae]

Hello, familial dilated cardiomyopathy appears to run in my family.My father was diagnosed with end stage DCM at age 44 and died at age 47. My brother was diagnosed with end stage DCM at age 33, received a heart transplant 2 years later. He died at age 41. I am 43. I recently had a screening echo which shows my EF at 45% to 47%. Four years ago my EF was 60%. I have recently become very aware of palpitations and have been experiencing shortness of breath. I do have a mild mitral valve prolapse with mild regurgitation. I am a healthy weight with very healthy colesterol and normal blood pressure. But my reduced EF concerns me especially since it is now in the below normal range. Could this be an early sign of cardiomyopathy?

[mmfd]

I hate to say it, but it certainly could be DCM.  What size is your left ventricle?  Is it already dilated?  You should be on a beta blocker and an ACE inhibitor if it is.  Ask your doctor about that.  You can catch it early and it may not progress any further.  The drugs now are wonder drugs, like Coreg.  Eat right, exercise regularly, don't stop any of the meds and watch your sodium intake, and you may never get worse.  I am not a doctor but I have DCM and so does my sister.

[LaRae]

Thank you for replying. The size of my left ventricle is in the normal range. I recently had a MUGA scan and went through a 24 hour holter experience. I am still awaiting those results. I know that cardiomyopathy can be asymptomatic in its early stage. That's why screening echoes are recommended for family members of DCM patients and I do want to catch it as early as possible should it ever manifest in any way. One thing that confuses me is: other than a dilated left ventricle what other "early" signs should I be aware of when I get my latest test results back? A low EF? Is that enough? I just want to make sure nothing is over-looked. By the way, have you and your sister gone through genetic counceling? Thanks again!

[mmfd]

Hi.  We have not had genetic counseling but most of our siblings have had screening echos, as did my 2 boys.  We are also enrolled in a DCM study for familial DCM.  A dilated left ventricle is not an early sign, really, it means you have it already!  But that doesn't mean that it will progress given the correct therapy.  Try not to worry....medicine has made a lot of progress in the past 10 years or so for cardiomyopathy.