Low EF

[Ptuner]

I had my first echo in 2005 and it showed a EF around 15.  I changed cardio docs to get one with a more positive outlook.  An artereogram showed no blockages of the arteries.  I picked up my exercise level after getting the news in part to prove the docs wrong.  My current walking distance is around 5 miles and can do it in about 1 1/2 hours without overextending myself.  One day I took along GPS unit and I was averaging 3.3 mph.  I don't feel that I have any obvious limits, but would not be dumb enough to train really hard.  I am 61 years old. There is obvious damage to the left ventrical as seen on an echo stress test.  I am not aware of ever having a heart attack.  I have had a left bundle branch block first discovered at age 20. My EF was ok at age 33 as seen on an artereogram that I requested to have done to try and find out why I had the LBBB.  They guessed that it was a virus.  Something has made the heart worse since age 33, but they don't know what did it.  The only reason the doc did the echo was because after age 60 he starts to think that people are getting old.  I don't look that old and try to stay active.

My question is this: "Does this scenario seem very unusual to you?"  I have increased worry these days because of the findings.  Those that write in worrying about being a few points under 50 should feel lucky.

[Ptuner]

I fogot to mention that my left ventrical is about twice as large as it should be.  The right ventrical is normal.  When I walk, my breathing hardly picks up at all.  I assume the good right ventrical has something to do with that.  I take Coreg at 12.5mg per day; 1/2 in morning and the rest in evening.  Some doctors would have me taking a larger does.  My newest doc at the Heart Place in Dallas seems to have a feel for how I am doing.  He hasn't been getting totally freaked by the numbers.  He did at first push me to get a defibrilator implanted; but since I have been doing well and can exercise well, he stopped pushing that on me; although he mentions it at times almost as an aside type comment. On my 5 mile walk I do take a break at the half way point.  My actual average is probably less than 3.3 mph, but that was the speed most of the time when I checked the GPS tracker that I carried once.  I am not trying to set any records at this point.  My blood pressure is good and arteries are clear.  Is Coreg a beta blocker?

The docs at first were also recommending Enalaprl; but since my pressure is good, they have relaxed on that. They don't want the top number to get below 100.

I was having some pvcs yesterday, but have been under some stress dealing with a Mother in transition and perhaps needing assisted living.  I may go for a Halter monitor if that keeps up.  

EF of 15 isn't the end of the world.

Fred

[Flycaster305]

I'm 65 years old, I'm a walker with an EF factor that increased from 35 to 46 after an agressive medication regimen of Coreg and Altace; I've had multiple stents and heart attacks.  If you are walking 1.5 hours at a 3.3 mph rate, I'm guessing that your EF reading is very inaccurate; for people our age, you are doing great!    I keep in the back of my mind that my walking is my informal stress test.  When I start to consistently feel winded, it's time to visit the Doc!  I would agree that a stress test is needed, and if it shows problems, an angiogram will pinpoint problems. Echos are only as accurate as the person administering the test.  You obviously have problems but if I were in your shoes, I'd want additional answers.  Good Luck, and it would be interesting to know how your second doctor procedes.

[anacyde]

Thank goodness for the echo, at least now you know what is going on and you can take steps to manage it.

15% is very low, as normal shouldn't be below 50%.  If they suspect a virus did this, then it's dilated cardiomyopathy.  Did they mention treatment (i.e. ACE I, Beta blocker, etc.) or a next step for you?

The good news is that how you feel is a better predictor of your outcome than your actual EF.  If you can tolerate exercise, and you've been cleared to stay active (most doctors will encourage you to as long as you feel good) then you're doing something very positive for yourself.  I do think I would get a second opinion if you're left with a lot of questions.

As far as unusual, dilated cardiomyopathies are one of the more common heart problems.  15% is quite low though, but with treatment (like the ACE-I and beta blocker) many people will see improvement, sometimes modest and sometimes dramatic.  I hope you get some better news in the new year and see some improvement soon.

[CollegeGirl143]

have you had an exersize stress test? If i where you, ide find a new doctor who is more open to trying to find out WHY your left ventricle is damaged, rather than just accepting it, especially if its causing you such a problem..Thats a very low EF, and ive seen people who have had multiple severe heart attacks have a better EF, so ide definatly get a second opinion from a major heart institute if possible.