Help understanding Ejection fraction

[tg8rd]

My boyfriend had a massive MI back in October they went in and placed a stent. A month later he was back in the hospital with the same problem and they found another blockage so the put another stent in. Then a month later he was back in the hospital with a new kind of chest pain that he had never had before. The did the cath and found nothing wrong this time. When he went back for his follow up from the last cath his cardiologist told him that 2 more trips to the hospital with his heart and they would have to put a defibrillator in. With no explanation or anything so when we went to his PCP he explained it to us that his ejection fraction was 30% and they normally put like to put one in at 35% but after doing research I am complete confused because what I just read normal healthy individuals ejection fraction is between 50 and 65%. So I was just wondering if someone could help me understand this because I am confused.  

[kenkeith]

Yes, your friend will most likely require medication and periodic monitoring of the heart's functionality, and medication can reduce the heart's workload and increase contractility.  Frankly, (generally) the variations of the estimated EF that are below the normal range isn't any prognostigation other than it is not pumping adequately and requires intervention.  An exception would be stem cell therapy to reconstruct damaged heart cells for normal contractions.

Many people live normal lives with an abnormal EF as the system can/will compensate.

[tg8rd]

Thanks for explaining that. But I am still a little confused because the doctor said that if it got to 35% they need to put a defibrillator in. But if it goes back up to 35% isn't that good news and not bad news. Because right now he is at 30%. The only reason I am trying to figure this out is because when he had the first MI they told me it was at 20% then after the second stent they said 40%. Then when he had the last cath procedure they said it was between 30 and 35%. SO does he need to keep having this checked. This is all new for both of us. His heart problems just came out of the blue and he is only 38 years old and has a 4 year old that he wants to see grow up.

[kenkeith]

Defibrillation is a process in which an electronic device sends an electric shock to the heart to stop an extremely rapid, irregular heartbeat, and restore the normal heart rhythm.  An electrical impulse irregularity  would prevent the heart from pumping effectively as there isn't enough time to adequately fill.  The ejection fraction (percentage of blood pumped into circulation with each heartbeat) with irregularity does not provide enough time for the heart to contract (pump) as well.

When there has been a heart attack (MI) the heart muscle is usually damaged, the damaged muscle does not contract normally and the amount of blood pumped out into circulation is reduced (low EF). Normal is about 55 to 75%...50 to 65% could be recognized as normal but consensus is 55-75%.  An EF below 29% is considered heart failure indicating there isn't enough oxygenated blood pumped into circulation to meet the system's demand.

Apparently, there is heart impulse irregularity (arrhythmia) associated with heart muscle damage that decreases EF.