Do I have CHF?

[mojogal]

I was in the hospital for a week. I was first told I had pneumonia then I was told I had CHF. I had a fever.
Now that I am not on a daily IV, I am not swollen. How can I know what I really have?

[Chance63]

Sorry. I meant that I just don't understand that low of an Ejection Fraction. Does it take long for an EF to raise back up? Also, I take 4x 20 mg of brand name Valium for various coexisting conditions including complex anxiety disorder. Even though that's not a blood pressure medicine, shouldn't it help by reducing anxiety and stress. Right when my BP started to spike, my pharmacy had switched from the same diazepam I had for 6 yrs. to really cheap, awful stuff. My anxiety escalated pretty much as my BP began to rise. So I got brand name approved starting this month. I realize I need to lose weight (which is what I was doing before I got sick). I just don't understand if Zi was exercising with no problems, eating mostly vegetarian and taking vitamins, how anything other than a freakishly stressful two month period resulted in passing out. I have never passed out. The paramedics measured my BP as normal! It was 209/102 earlier that day. Could that event have caused some of these results? Could hypertension be effecting my kidneys or could something other than hypertension be causing this low Ejection Fraction? Do EF fluctuate like BP? Although my echo and MUGA were weeks apart so they were consistent. I just have had no one explain this to me. No discussion of echo..Dr. Said he didn't think it was that bad o I happily considered it all a fluke. But then he wanted a MUZgA to be sure. Then I had no followup to discuss ANY of it. I had to call just to get a script. I am going to a cardiologist late February but would like to go in sounding a bit more informed so I understand him. Should I request a full blood panel ? I am 49' never had one..everyone in my family has! I didn't understand the instance on just a lipid panel?

[Chance63]

Hello. I am 49. I was recently diagnosed as having early stage heart failure due to long term hypertension. An echo listed things the MUGA did not (concentric remodeling, global systolic dysfunction). The EF was 35-40. MUGa said that my EF was 38 and mentioned global hypokinesis. So I was put on Diovan. It's been a month, my systolic has dropped but my systolic hasn't budged. IT's always been 90-92. I am only on 80mg and read that the dosage is often doubled, which is fine with me, I have no side effects. In 2004 a cardiologist diagnosed me with 'dilated congestive cardiomyopathy" after  2 stress tests and an MRI. I lost weight, stopped drinking, left stressful job and home life, and he told me I was fine. I never worried about it after that. Doctors never told me I had hypertension. I used to get it tested often for ECT. It was only a few months ago that I had another period Od massive stress. My blood pressure kept climbing in a few brief months until II hit 200/102 and I passed out. Prior to that, I was walking 2 hrs a day, eating mostly vegetables, low sodium intake. After I passed out, I had terrible fatigue, fell off diet and blood pressure went down to about 147/90. At the cardiologist office it measured normal! So the echo and MUGA show an Ejection Fraction at 38! Now I am being told that I had long term hypertension and have early stage heart failure. Passing out was called a "Critical Hypertensive Event" that happened the day it hit over 200 but after that went down lower. Anyway, I have been on 80 mg of Diovan for a month. Systolic is down to about 138 but diastolic doesn't budge. Indications for tests both in 2004 and just the end of 2012 say cardiomyopathy, but no one since 1 cardiologist has ever told me I have that.So do I just have hypertension, with most symptoms being reverse able? Other than the low EF, most things seemed normal range on my echo:
Heart Rate: 98bpm LV-EDD 44mm Interventrical Septal Thicness:11mm
LV Mass 145gm LV Ooutflow velocity: 105cm/sec LA Volume 54ml aortic Root 34 mm Diastolic Mitral E velocity: 58 cm/sec Mitral E/A : .786
TDoppler Mitral E septal annulus:13cm/sec Tissue DopplerE/A: .782
Tricuspid regurg gradient: 6.444 mm HG
Tapes:19 mm blood pressure: 150/99/HG LV End -systolic Diameter : 25mm
Posterior Wall Thickness: 9mm
LV Mass index: 60gm/ meter squared Left Atrium:33 mm
Aortic V peak velocity: 153cm/sec  Diastolic Mitral A Velocity: 74cm/sec
Mitral Valve Decel Time: 240 mescal TissueDoppler Mitral E annulus: 11 cm/sec TD Mitral a lat Ann. 58/9 (??) RV -EDD 39 mm
Left atrium :normal size left Ventricular. Moderate global systolic dysfunction. Concentric left ventricular remodeling. EF: 35-40.
Aorta: Normal root size
R Atrium: Normal  Atrial Septum: grossly normal
Right Ventr. Normal right ventricular size/systolic function. Pulmonary artery: normal size pericardium: normal. No pericardial effusion seen
Cardiac Masses: None seen.
Trileaflet aortic valve, normal leaf thickness, excursion, valve velocities, no stenosis. Mitral Valve: no mitral regurgitation.

Summary: normal left ventricular size and moderate global systolic dysfunction.
Concentric left remodeling
Abnormal insertion of a high septal papillary muscle noted in some views.

That's it! Pretty much everything is mostly normal.

The MUGA simply said :left Ventricle EF: 38 %
L ventricle wall motion: upper Normal with moderate hypokinesis.

So no mention of any kind of cardiomyopathy. All I see is a surprisingly low EF (my last test in 2004 was 53). Further I was told that no stress test was needed, when in 2004 that was the first thing they gave me.

So I am assuming I do NOT have cardiomyopathy. I guess I am hypertensive, but before the event of my BP spiking, I had lost 60 pds (healthily, walked 2hrs a day, took vitamins). Heavy stress, BP spikes, I pass out, then I go fatigued for about a month and gain 30 pds back).
My hospital doctor never reviewed anything on these tests with me. His receptionist simply called me in a script of Diovan.
Going to cardiologist specialist at the end of Feb. that will be 2 months of Diovan. I guess I just have hypertension, perhaps early stage heart failure signs, most of which are reverseable? Just low salt, exercise, weight loss and BP med? I read I should have had a full blood panel to check kidneys, liver, rule out Diabetes. All I got was a lipid panel. Cholesterol ok, triglycerides fine.

I just don't understand an EF that high! I don't understand my Diastolic stubbornly staying around 90.

But I want to rule out cardiomyopathy which no doctor has.

[Jonathan D. Rich, MD]

Hello and welcome to the forum:

I would suggest you ask your physician for your diagnosis.  If he/she tells you it is "CHF" please ask for an explanation and come prepared with a list of questions to ask.  Do not be afraid to approach your doctor.  Unfortunately, since I do not have any information at my disposal, I certainly can not tell you at this point whether you have CHF or not.

All the best,

Dr. Rich