29 y/o + Mildly depressed EF

[kkw]

I am 29 yr, overweight and was diagnosed with MVP from an ECHO in Feb.  The cardiologist referred me for further eval bc it also showed an est. EF of 45%.  I took a MUGA scan in Sept which confirmed this.  EF was 47.8%, I had also started Lisinopril from my visit 1-2 wks prior.  I was then sent for stress thalium to rule out CAD in which it came back negative and an increased EF of 62%.  I also have had symptoms of extreme fatigue very often, chest discomfort, inc HR, and swelling legs.  The cardiologist believes my symptoms are most likely due to MVP and not a major heart condition.  I would like to believe that and it does make sense from the literature but the reason as to why my EF was low in the first place is still unanswered.  He also mentioned a virus could have caused the EF situation but I doubt a virus from Feb-Sept.  He increased my Lisinopril to 20mg.  What other conditions could cause my EF problems?  The cardiologist says that EF fluctuates all the time but it is just odd to me that from Feb - Sept it is approx in the same range and only improved once I got Lisinopril.  I never have been diagnosed with HTN but my BP did fluctuate alot meaning sometimes in the pre-HTN stage.  Please advise as I am very frustrated that this is taking so long to find out what to do.  I would love that it be simple as MVP but the EF bothers me.  What should I do? They also eluded to f/u for CT diseases as a cause of the EF problems.  I was tested some years ago for Lupus and sarcodosis when these symptoms 1st arrived but they both were negative.  The swelling in my legs do not occur continuously but usually it occurs when I am not feeling my best and usually present w/ the fatigue.

[kkw]

No, I have not been tested for sleep apnea and it doesn't appear that this is an avenue to explore because I've never had any issues that point in this direction.  I guess this is just a mystery?  I  thought that I could get another opinion of what direction to head in for answers but none of the hypotheses listed above describe me....  

[Douglas Bogart, MD]

Have you been tested for sleep apnea??  This can be a cause for a decreased ejection fraction..I doubt the decreased EF is due to MVP.  The common things for this are:  XS alcohol intake, a viral infection affecting the heart or unrecognized hypertension.

[kkw]

I forgot to add that the echo showed mild-mod regurg.