congestive heart failure

[betazoida]

In December 2008 I was diagnosed with CHF.  I have since undergone the echocardiogram procedures from the hospital check in and another in the cardiologists office; and the cardiocatheterizatoin procedure whereby dye is injected into my arteries and the surgeon has a look see at my arteries.  On the first diagnosis at the hospital I was told my heart was functioning at 20% capacity.  On the 30 day follow up from hospitalization  and another echocardiobram  I was told my heart function was up to 30%.  My lisinopril went from 10 to 20 mg.  On my 30 day follow-up office visit from the following cardiocatherization I was told my heart was functioning at 25% even though I was feeling better than before I had the cardiac event in December. Even though I was feeling better the doctor increased my lisinopril to 40mg.  I don't get it.  I asked him why, he answered that he wanted me to start on the 40mg in the first place.  I don't get it. According to what I can find out, the lisinopril slows down my heart. Is it supposed to get slower and slower to the point that it is barely beating? I don't get it.  Please help if you have a different perspective. Every time I think about my non-progress I become very sad and feel hopeless.

[Dr J Singh]

Hello,
The treatment started by your cardiologist by introducing 40 mg lisinopril is absolutely correct and in the best of your cardiac condition.The effective dose range for treating heart failure is 5-40 mg daily.

Lisinopril decreases the after load on the heart and decreases BP by reducing vasoconstriction which in turn benefits the heart.Since your EF is 25-30 %,so a high dose of lisinopril is desired.Studies have shown that patients with moderate to severe CHF(EF<20%) had 12% lower risk of death or hospitalization for any reason, if placed on a high dose of ACE inhibitor like Lisinopril compared to a low dose.

I would suggest that you comply with your doctor’s prescription as high doses of lisinopril significantly reduces mortality in CHF patients.

I hope that helps.Take care and pls do keep me posted.

[Encephalomalcia]

Lisinopril takes pressure off the heart and even eyes if a person has glaucoma.  Pressure buildup in the heart can lead to further heart failure.  Usually, doctors want the blood pressure to be low to take the workload off of the heart.  The percent of which your heart is working, does not mean that there is less pressure in your heart.  Lisinopril is an ace inhibitor and has proven studies showing that it can extend ones lifespan unlike beta blockers.  Blood pressure should be below the normal range of 120/72 and the heart rate probably in the 60's or a little higher.  If your blood pressure is above normal, it is too high.  Same with your heart rate.  Lisinopril is a great medication to be on when there are heart issues.  Doctors start patients off at a lower dose and work up gradually to the dose that the patient should be on, so that their body adjusts to the medication slowly.