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exercise tolerance in LV dysfunction

Is exercise advisable to a patient with severe left ventricular dysfunction? If yes how much? how should his activity be controlled? He was diagnosed to have by an echocardiography following an MI, septal and anterior wall hypokinesia. But  he is asymptomatic. He also had h/o MI 8yrs back and CVA 4months back. He is 50yrs old now.What treatments can be offered to him? what is the prognosis? how should his diet and life style be modified?
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242509 tn?1196926198
He may exercise aerobically, and with monitoring of his heart rate. If he is 50, his maximal heart rate should be around 115-120 bpm. If he develops symptos or signs of angina or CHF before reaching that target, then he should moderate his efforts. I would advise against heavy lifting, as this can raise blood pressure, and affect LV performance.
He is certainly a candicate for established medical therapies with beta blockers, ace inhibitors, aldosterone blockers and digoxin. He may also need a defibrillator or a special 3 lead pacemaker system. These options, however, are offered on a case by case analysis, and he may not need or benefit from them.
In this age group he should be seeing a CHF specialist which besides offering all of these treatments can start looking into the future and see if he is a candidate for transplant and begin the process before his condition deteriorates.
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