Ejection fraction

[bigboi59]

Hello I have a question,
I have been diagnosed with Cardiomyopathy, Atrial Fib (AF), Congestive Heart Failure (CHF)and an Enlarged Heart back in 1998. at that time my (EF) Ejection fraction was well over 60%. I went to my Doctor the other day and found out that my (EF) is at 30 - 40% from a EKG/Echo cardiogram report that dated back to 07/19/2005 now three years have gone by and now I'm worried. I was told by my primary care physicians practitioner for which she brought to my attention the results of this report that was dated three years ago. The practitioner advised me to see a cardiologist and suggested I may need a defibrillator implanted. My visit with a cardiologist is this coming Monday. Now! I have been hospitalized at least six times the most recent about two years ago. for (CHF) and (AF) and not once has the attending cardiologist of the hospital ever discussed anything about my (EF) percentage rate which I'm sure it has to be of a lessor value at this time. This has me stressed out big time. and I can only say that knowing what my (EF) was from 3 years ago at 30 - 40% without any advice! I can only think it has caused more sever damage to the heart. I need some answers to the severity of this condition. I feel that my primary care physician and the members of his staff and group where very neglectful in this matter. any advice would be appreciated in regards to filing a case against them for there neglect to inform me of this (EF) report.

Thanks,
Al
bigboi59

[kenkeith]

What is your understanding for the underlying cause for a regimen of digoxin, furosemide, carvedilol, enlapril, coreg etc., if the test revealed no blockages?  Did you have an illness that damaged the heart muscles...congenital, alcohol, drugs, medication, etc.?

[bigboi59]

Thanks, will do the yellow pages.

[bigboi59]

My last and only cardiac catherterzation that was done dates back to 1998 - 99 and those results showed no blockage anywhere at all. I also had an (MRI) done around the same time, at first they thought they seen spots behind my lungs but that turned to be OK. after these test where done the first cardiologist told me that because my (EF) was over 60% that I don't need to see him and that I only need to see an internal medicine Doctor. and that EKG's / echo's can be performed in the office.The only treatment since 98 - 99 has been medication:

CARVEDILOL         12.5 MG TABLET MYL         TWICE DAILY
FUROSEMIDE            40 MG TABLET MYL 2- TABLETS TWICE A DAY
METOLAZONE          2.5 MG TABLET MYL         ONCE DAILY AT 10 am
KLOR - CON                  M20   TABLET UPS 2- TABLETS TWICE DAILY
LYRICA                      75 MG CAPSULE P-D 1- TWICE DAILY
METFORMIN          HLC 850 MG TAB ZYD         1 - TAB TWICE DAILY
WARFARIN   SODIUM       7 MG TAB BRR         1- DAILY
ENALAPRIL  MALEATE     2.5 MG TAMYL         1- DAILY
SPIRONOLACTONE         25 MG TAB MYL         ½  - TABLET ONCE DAILY
GLIPIZIDE                         10 MG TAB WAT 1  - TABLET DAILY
ISOSORBIDE  MN           30 MG TAB WSW 1 - DAILY
DIGOXIN                250 MCG TABLET LNT         1 - TAB DAILY

[kenkeith]

Reading your post raises questions and you should have/know the answers to have a good understanding of your situation.  It seems if you were dx'd (1998) with CHF and left ventricle hypertrophy (enlargement) your EF should have been less than 30%, not 60%, to be consistant with signs and symptoms of congested heart failure.  This would be true as heart failure congestion is caused by the inability of the heart to pump with some equilbrium for the blood received from the lungs and this would cause blood to backup into the lungs and fluids would/will leak into the tissues causing congestion (pulmonary edema).

AH/AAC guidelines acknowledge less than 30% to be the medically acepted range for heart failure, but it may be possible, I suppose, to have pulmonary congestion with an EF higher than #)%...such as a respiratory problem and a weak pumping heart, I don't know!  

With AF, atrial fibrillation may occur without evidence of underlying heart disease. This is more common in younger people, about half of whom have no other heart problems. This is often called lone atrial fibrillation. Some of the causes not involving the heart include the following: Hyperthyroidism (overactive thyroid), alcohol use, pulmonary embolism (a blood clot in the lungs), pneumonia.

Or most commonly, atrial fibrillation occurs as a result of some other cardiac condition (secondary atrial fibrillation). Can br heart valve disease: This can be something you are born with or be caused by infection or degeneration/calcification of valves with age.

Enlargement of the left ventricle walls (left ventricular hypertrophy), coronary heart disease (or coronary artery disease): This results from atherosclerosis, deposits of fatty material inside the arteries that cause blockage or narrowing of the arteries.

High blood pressure (hypertension), cardiomyopathy (disease of the heart muscle) leading to congestive heart failure. Sick sinus syndrome (improper production of electrical impulses because of malfunction of the SA node) and pericarditis (inflammation of the sac surrounding the heart).

You don't mention any treatment for an underlying heart problem?  To get some answers to the questions I have raised, would enable you and your doctor to determine the severity and proper treatment currently and in the past..

[BionicBabe]

Al,
I don't have any advice to give about filing a claim against your practicioners, but my guess is the Yellow Pages are probably full of malpractice lawyers. I know you must be frustrated. Just finding out one has heart problems is devastating enough in itself, but to feel like you haven't been given vital information that could have led to getting appropriate treatment sooner as opposed to later must be extremely aggravating. I hope you are able to work it all out and find some good avice from someone you trust!