Can the blow flow in your heart improve after a heart attack?

[nicki0327]

My dad had a heart attack in 2004.  Since then he is very active, reduced his smoking considerably, cut salt out of his diet.  He recently had an angina due to a family emergency and had to have a stress test to make sure things were okay.  The cardiologist has told him that when he had his heart attack there was 25% of his heart still working.  After the recent stress test they told him that 30% of his heart was now working.  How is this possible?  Does that mean that the other part of his heart died?

[kenkeith]

I realized you made a typing error, but I wanted to be sure it was not 2006 or later.  I began to have changes in echo reults after about a year..

[sukumar794]

While thanking you a lot for the valuable information, I regret the  error in typing.My heart attack was during October,2007.Diagnosed as CAD,Anterior wall MI.

[kenkeith]

The underlying cause for the heart attack has a significant role in determining prognosis.  If the ha was ischemic (CAD) in nature, there is a probability the heart cells affected  are dormant (hybernating is the medical term), and the heart cells can regain the properties to interact with other heart cells for adequate contractility of the left ventricle.

Generally, medication can dilate vessels as well as a stent implant, and the improved distribution to dormant cells can revitalize those cells.  Medication also reduces the heart's workload and that aids and helps the heart to reduce LV size (or prevent enlargement) etc.

I believe your heart attack occurred on October 2007 and not 2008 (or 2006?!), and you should be having another echo soon to determine if there remains any heart-wall movement impairment and the current EF.  

Contributing factors for a favorable outcome is exercise (you're doing that), heart healthy diet, medication to reduce plague, etc.

[sukumar794]

Will medications bring in a welcome improvement in EF.Mine was 26% following a heart attack in October,2008.I am on regular medications and walk regularly for half an hour during the morning and evening.How can anyone evaluate the damaged heart muscles as not dead? Will the supply of blood/oxygen to the area of impairment be facilitated by medications. Thanks in advance.

[kenkeith]

A heart attack damages heart muscle and the muscle impairment reduces contractility and the cardiac output is reduced.  The measurement to determine cardiac output reduced by heart muscle damage is estimating with an echo test the voulme of blood pumped out with each heartbeat.  The EF (ejection fraction) is the calculation and that calculation is the amount of blood pumped out in terms of a fraction.  Your dad's EF is 25-30%.  Normal is 55-75% and heart failure is below 29%.

Four years ago I had a heart attack and my EF was below 29%.  Mediation has returned my EF to 59% and heart muscle damage has diminished.  Sometimes the damaged heart muscle is not dead, and when the underlying cause is corrected such as open vessels to feed a good supply of blod/oxygen to the area of impairment the EF is increased..