Can you have more than 1 type of dilated cardiomyopathy?

[Ingrid930]

47 year old female.  RA meds caused atrial fib, then congestive heart failure and tachycardia-mediated cardiomyopathy.  Meds seemed to have cured the cardiomyopathy and I had a normal echo.  Then atrial fib got worse, and then when having CT scan to measure for ablation found widespread enlarged lymph nodes throughout my chest and abdomen.  Findings were stage 3 Large Diffuse B cell lymphoma.  Since I already had the heart problem, had echo to confirm normal ejection fraction, and then had echo after each treatment.  It was not until after 3rd treatment that ejection fraction took a nosedive.  Stopped the adriamycin, but damage apparently already done.  Day after PET scan showed complete remission of the NHL, had TEE that showed blood clots in my heart and I was in atrial fib (180s) consistently.  Admitted to hospital.  Something bad happened that night and I woke up the next day with an inter-aortic balloon pump.  Told I had gone into cardiogenic shock, and as a last resort they put in pump.  In a few days I had it removed and had pacemaker and defib ICD put in.  My question is, could I have had tachycardia-mediated cardiomyopathy that was resolved prior to me taking the chemo, and then could I have gotten dilated cardiomyopathy due to the chemo drug?  Newest echo shows ejection fraction back to normal but change from mild mitral valve regurgitation to moderate...my symptoms are now like the CHF I suffered at end of chemo?  Is this a bad sign that my dilated cardiomyopathy is now progressing to end stage?

[Ingrid930]

I have been told that ejection fraction is not a fixed number, that it can change day to day, hour to hour.  Since my ejection fraction in the past 3 years has been as low as 10% at least 3 different times, and less than 35% about 10 times and only above 50% 4 times...I know how quickly it can go up and down.  Obviously, the type of test used to determine the EF also makes a difference.  I had one done with angiogram (10%) and at least 3 with TEE prior to cardioversion (20% or lower), and one during cardiac catherization (15%).  I was told the angiogram and cardiac catherization were the most reliable and that TEE is more accurate than a regular echo.

My concern is that with dilated cardiomyopathy, having worsening mitral valve regurgitation is an indicator of progression of the disease.  I just want to know if I am heading down that path and how short of a path it is?  I am a single mother and have a 10 year old daughter.  My symptoms make it hard for me to function completely and I just want to know if this is how I will feel for the duration.

[grendslori]

If you EF is back to normal, why do you feel you are progressing to end stage?