I'm a Little Scared - Diagnosed w/Nonischemic Cardiomyopathy

[ColetteIA]

I just got released from the hospital yesterday and diagnosed with Nonischemic Cardiomyopathy. I had an Angiography that showed normal coronary arteries. Cath Diag (EF, Mild Anterior/Lateral/Apical Hypo, mild NICMP (IMMC-MCF)). Stress Echo showed baseline EF estimated at 40%. With exercise there was accentuation of baseline ST abnormalities, with 3 mm downsloping ST depression noted. This persisted 6 minutes in recovery. Positive exercise ECG. With stress, there was augumentation of cardiac function, although the anterior wall improved only minimally. Given baseline LV abnormalities, findings consistent with cardiomyopathy with impaired contractile reserve. Anterior ischemia not included. I've been placed on .25MG METOPROLOL (once daily).

I'm a little scared. Please tell me:
1.) Is this diagnosis serious?
2.) Is this medication the best offered on the market?
3.) Can this condition be reversed? Is so, how?
4.) If I'm ever diagnosed with cancer, will I not be a candidate for treatment?
5.) Should I get a second opinion?

Thanks so much in advance!

Colette in Iowa

[kenkeith]

Hi, Athena.
Colette, 29% EF is the recognized threshhold for insurance disability, etc.  Some people function well with an EF below 30% because the low cardiac output meets the system demand for blood/oxygen...well compensated.  Also, of interest is it is estimated that apoproximately 26% of the heart disorder population has an EF in the heart failure range and go about there daily activities without any knowledge of their conditiion.

When I went to ER for shortness of breath, I learned I had had a prior silent heart attack, and an EF from 13% with a cath and 29% with an echo.  I was stunned to know I had a heart problem...thought it was respiratory...I functioned well with walking. etc. Heart failure range is a classification with varied functionality.

>>>>"SSA Listing criteria for systolic heart failure include

■Left ventricular end diastolic dimension greater than 6.0 cm (indicating a dilated left ventricle) or
■Ejection fraction (EF) of 30 per cent or less
These measurements are usually found in an echocardiography (ECHO)/heart ultrasound report".

[wsteve]

I've been living with IDC for fourteen years. That you're not taking digitalis, prinivil, lasix and warfarin is excellent IMO. I'm not a doctor, but I must respectfully disagree with kenkeith on the 29% EF being considered heart failure. I know someone who has an EF of 20% and he walks nine holes. Slowly, but he does it.
So many factors involved with many of them necessarily dependent on ones individual physiology.
*exercise and grade CoQ10 IMO are essential.

[AthenaSB]

hang in there.  I too have DCM and my EF is 27%.  Also non ischemic.  I had a bad stress test and then MUGA scan and echo showed the DCM.  Your EF isnt too bad... like kenkeith says there.  He knows a lot about this and has had improvement in his own case, which has sure given me hope!

[kenkeith]

1.) Is this diagnosis serious?

>>>An EF of 40% is the amount of blood pumped with each heartbeat.  Normal is 50 to 70%, and heart failure is 29% and below.  Some poeple do well with an EF that is below normal because the cardiovascular system compensates.  The dx is non-ischemic
cardiomyopathy (NICMP) enlarged heart.  The condition is mild.

2.) Is this medication the best offered on the market?

>>>Your medication is to treat high blood pressure and help overcome any heart related chest pain (angina).  High blood pressure can enlarge the left ventricle and this condition can reduce the EF.

3.) Can this condition be reversed? Is so, how?

>>>"Hypo"  Means hypokinesis which is  some heart wall movement disoerder.  Can be due to some damage of heart cells from prior heart attack.  Usually it is ischemia (lack of blood flow due to vessel blockage) but your situation is non-ischemic.  Sometimes the damaged heart cells are revived with therapy.  Reduced the workload of the heart can reverse remodeling (heart size).

4.) If I'm ever diagnosed with cancer, will I not be a candidate for treatment?

>>>I don't know the implications involved with cancer and treatment and heart problems.

5.) Should I get a second opinion?

>>>Follow your doctor's instructions for therapy.  May be a little early for a second opinion.