Estimated left ventricular ejection fraction of 44%

[Lump]

I am 49 years old - male - and in good health.  I have recently lost approximately 130# over a 15 month period.  Exercise regularly and maintaining a healthy diet.  Blood pressure and blood chemistries are all within normal ranges (BP 132/70, cholesteral 185).  Stopped taking blood pressure medication (Avalide Tabs 150/12.5) approximately 2 months ago with Dr.'s concurrence.  Smoke approximately 1-1/2 packs cigarettes per day.  GP diagnosed a slight heart murmer aprroximately 3-4 years ago, due to a slight deformity in a heart valve.  Has watched it thru periodic echo-cardiograms and stress tests.  Most recent nuclear stress test, although indicating no evidence of stress induced ischemia, nor any significant blockages or thickenings, did note an estimated left ventricular ejection fraction of 44%.  Although not expressing any great concern, the Dr. has recommended follow-up with a cardiologist (which I'm in the process of doing).  My questions are - what does this mean?  What causes it?  What do I do to control or improve it?  What are longer term consequences and/or prognosis?  The Dr. has indicated I can maintain current exercise/activity levels, but has recommended I not take up jogging (which I'm not contemplating anyway).  Any information that can be provided to help understand the answers to these questions would be greatly appreciated by both my wife and me.  Thank you.

[coonie]

I was wondering what 40 percent ejection factor meant and is it life threatening.

[Luki2beAlive]

Well far from a doc. here also. But I'm beginnig to learn more and more. I am barely 38yrs old and have had 2 heart attacks. My 1st, at 37, I didn't accept, just was in total denial that my strong, seemingly healthy body could even go that direction. I brushed it off as,living alittle to wild in younger yrs. Under too much stress, I just needed to slow down on things. Not stop, surely not!!!! Just slow down. Well,oh how wrong I was. My 2nd came with great force ---- This one massive. I passed out, and awoke to find I had died several times, almost was unable to be stablized enough for surgery. And had been so unresponsive they had concerns of brain damage due to passing away for minutes at a time. My 1st was a SPASM attack, a cath was done and all seemed well, but I continued Smoking, and began my fast life again and within 7-8 months was facing death. It is not to be played with, your heart is the motor of our bodies. If it requires exercise,diet changes,and stress management, then so be it. We work on our cars don't we? Maintenance is all it is. And it can help get a stronger ejection fraction. I'm living proof. It works if you do! You may want to read up on Dr. Ornish diet also, it is said to reverse heart disease. For dedicated people only.
    Now I'm slowly recovering from open heart,double by-pass, viens were taken from my left leg to put in my heart. I'm recovering well, mentally and physically, but I must admit to those same fears of will I live a long life like my friends.

[HeartSmart4]

I am not a doctor either, however, I survived a heart attack and recieved a stent implant in 1999. I read your posting with great interest. Smoking is the number one risk factor leading to a heart attack. You need to quit now! I smoked 2 1/2 paks per day before my attack. I was and you are addicted to nicotine. Nicotine is more addictive than Heroin and Cocaine. See your Doctor today about quitting either "cold turkey" as I did or with a nicotine substitute such as the patch or gum. You can workout, eat well, and loss all the weight you want but your cigarette habit will kill you sooner or later, but sooner I bet.
Good Luck.

[sman]

I think you need to stop smoking like yesterday.  I'm no Doctor, but I keep up with the latest research and according to the latest, an EF of 40 and below puts people at risk of SCD (Sudden cardiac death).  Your smoking puts further stress on your cardio system by releasing Adrenaline and causing your blood vessels to constrict.  Exercise tolerance is the single most important indicator of heart health, more than cholesterol, blood pressure, smoking, body weight, etc.  So if you're fat, have high blood pressure, high cholesterol and smoke, but can get on the treadmill and rev your heart up to near its maximum rate and keep it there for awhile with a good ejection fraction of 65% or so (good luck), you are better off than a person with great numbers but can't get close to their max heart rate without getting out of breath quickly and have to stop and sit down.  Usually all of these indicators are controllable, but the most important is how strong your heart is. I would say quit smoking, go see your cardio, get a green light to exercise if possible, then start working to make your heart stonger and more efficient.

[CCF-M.D.-KE]

Ejection fraction:

The ejection fraction is the percentage of blood ejected from the left ventricle(the main pumping chamber) of the heart with each contraction. The normal value is 55%. From the nuclear medicine study you had it seems as though your ejection fraction is lower than normal(44%) which means there is a weakening of the heart muscle. The most common causes of this in our society are blockages in the heart arteries and high blood pressure. Medications such as beta blockers and ACE inhibitors are useful in this condition and may improve survival and possibly the pumping function of the heart. The weakened heart muscle can be associated with symptoms of shortness of breath and chest pain. This finding is also associated with decrease in long term survival which may be blunted by the above medications but not normalized. There is also an association with problems of heart rhythm.

I would recommend having an echocardiogram. Have your previous echocardiograms shown this abnormality? Before completely relying on the results from the nuclear medicine test I would see a cardiologist for a thorough cardiac examination and assessment of the heart valve problem along with reassessment of your left ventricle. It is possible that the valve problem may have lead to weakening of the heart muscle. However, I am hoping this finding is inaccurate, given that you have had prior studies which apparently did not show this.



Thanks for your question,


CCF-MD-KE