Aa
LV dilation and hypokinisis and EF 30% after MI
I am a 48 year old male, 6 ft and 76 kg. I had Ant wall MI in August 2007 with inferior wall ischaemia. Stent was inplanted in LAD with 100% blockage. OM2 100% blockage but filled by collaterals. By december 2007 I was taking 12.5mgx2 betablocker(carvidilol), 5mgx2 ACE-I(ramipiril), Monotrate 10mgx1, Aspirin 150x1, diuteric and Clopidrogel(anti platlet) 75x1, drug for cholestrol. I was able to walk 1.5 miles (35 minutes) and do my office worl(table job) without getting tired by evening. I was taking low fat, low salt diet.My EF reached 40% from 30% post MI.
In january 2008 I had syncope event. The tests were conducted, holter test, MRI, ecocardiogram(Mid ostial LAD has 30-40% plaquing, D1 medium sized and has 60% osteo proximal stenosis, D2 large and has 80% ostial stenosis, large RV branch has 90% ostial stenosis), angiography, electrophisiology study. None could establish syncope relation to heart. But my EF evaluated by cardiologist during angiography was 20-25%(although as per ecocardiogram it was 30-35%). Due to low EF I was implanted ICD. During this one month period my beta blockers anf ACE-I were reduced by half.
My recovery after ICD was reasonable I could return to original dose of betablocker(12.5mgx2) and ACE-I(5mgx2) with adition of Aldectone(12.5 mgx1) and my walking capacity increased. In march end I started feeling some tiredness. My doctor advised me to increase beta blocker by twice(25 mgx2), Monotrate was discontinued. But I started feeling tired, I could not walk at same speed as earlier, I had strange sensation in head and throat region. I was asked to reduce ACE-I. I was told that remaining blockages will have to be managed by medicines and diet at this time.
Now for more than three weeks I am taking 18.75 mgx2 betablocker, 5mg and 2.5 mg ACE-I and other drugs as above, i.e. Aldectone(12.5mgx1), Aspirin 150mgx1), Clopidogrel( 75mgx1) and for cholestrol. My Echo report one week back shows EF 30%, LV dilation, hypokinesis of LV walls except lateral wall.LV systolic velocities are reduced.
My interraction on this forum reveled that the dilation of LV is serious issue and until it starts remodelling by drugs longivity of patient with above conditions can be in doubt. Does someone has experience with these conditions or related information which can be shared on this forum. Can LV remodel itself with beta blockers and ACE-I? I have seen remarks/suggestions from reputed cardilogists and patients who share their experiences and all this is very useful for patients like me.
My questions are:
1. Are my doses of betablocker, ACE-I and Aldectone adequate? Do I need to add any other medicine?
2. What factors should be closely monitored, pulse rate low(how much?). My present pulse rate is 70-75 bpm 60% time, 75-80 bpm 20% time and 80-90 bpm 20% time during 24 hrs. My bp is consistant 105-110/70-75? Other physical conditions and symptoms required to be monitored?? What are indication of worsening situation?
3. How much walk, at what pace is advisable?(With my present activity regime my breathing remains normal.
4. Will my condition improve, EF, Hypokinesis of LV walls and LV dilation remodelling??
My thanks in advance to everyone who responds.
In january 2008 I had syncope event. The tests were conducted, holter test, MRI, ecocardiogram(Mid ostial LAD has 30-40% plaquing, D1 medium sized and has 60% osteo proximal stenosis, D2 large and has 80% ostial stenosis, large RV branch has 90% ostial stenosis), angiography, electrophisiology study. None could establish syncope relation to heart. But my EF evaluated by cardiologist during angiography was 20-25%(although as per ecocardiogram it was 30-35%). Due to low EF I was implanted ICD. During this one month period my beta blockers anf ACE-I were reduced by half.
My recovery after ICD was reasonable I could return to original dose of betablocker(12.5mgx2) and ACE-I(5mgx2) with adition of Aldectone(12.5 mgx1) and my walking capacity increased. In march end I started feeling some tiredness. My doctor advised me to increase beta blocker by twice(25 mgx2), Monotrate was discontinued. But I started feeling tired, I could not walk at same speed as earlier, I had strange sensation in head and throat region. I was asked to reduce ACE-I. I was told that remaining blockages will have to be managed by medicines and diet at this time.
Now for more than three weeks I am taking 18.75 mgx2 betablocker, 5mg and 2.5 mg ACE-I and other drugs as above, i.e. Aldectone(12.5mgx1), Aspirin 150mgx1), Clopidogrel( 75mgx1) and for cholestrol. My Echo report one week back shows EF 30%, LV dilation, hypokinesis of LV walls except lateral wall.LV systolic velocities are reduced.
My interraction on this forum reveled that the dilation of LV is serious issue and until it starts remodelling by drugs longivity of patient with above conditions can be in doubt. Does someone has experience with these conditions or related information which can be shared on this forum. Can LV remodel itself with beta blockers and ACE-I? I have seen remarks/suggestions from reputed cardilogists and patients who share their experiences and all this is very useful for patients like me.
My questions are:
1. Are my doses of betablocker, ACE-I and Aldectone adequate? Do I need to add any other medicine?
2. What factors should be closely monitored, pulse rate low(how much?). My present pulse rate is 70-75 bpm 60% time, 75-80 bpm 20% time and 80-90 bpm 20% time during 24 hrs. My bp is consistant 105-110/70-75? Other physical conditions and symptoms required to be monitored?? What are indication of worsening situation?
3. How much walk, at what pace is advisable?(With my present activity regime my breathing remains normal.
4. Will my condition improve, EF, Hypokinesis of LV walls and LV dilation remodelling??
My thanks in advance to everyone who responds.
Did you find improvement in EF with medicines? Although it may be too early to ask this question since you had MI in Oct 2007? Your name gives an impression that you have Indian connection. I belong to Delhi. I will love to share my experience of treatment with you. Please keep giving feedback about yourself. Are you continuing with your work?
My case is similar to that of yours.I am male,58 years of age. Had a heart attack in October 2008. Diagnosed as CAD with Anterior wall MI. Survived the attack with thrombolytic therapy in an ICU. Discarged from the hospital. I am put on medications including clopidogrel,carvedilol,Aspirin,Nitroglycerine,Eplerenone and statins.Ejection fraction in Echo finding was 26%. I am diet restrictions and regular walking for 30 minutes morning and evening. I do not feel much discomfort except for occasional spells of tiredness and restlessness. I carry with me a strong belief that conditions would improve .
Have an Answer?
You are reading content posted in the Heart Disease Community
Is a low-fat diet really that heart healthy after all? James D. Nicolantonio, PharmD, urges us to reconsider decades-long dietary guidelines.
Can depression and anxiety cause heart disease? Get the facts in this Missouri Medicine report.
Fish oil, folic acid, vitamin C. Find out if these supplements are heart-healthy or overhyped.
Learn what happens before, during and after a heart attack occurs.
What are the pros and cons of taking fish oil for heart health? Find out in this article from Missouri Medicine.
How to lower your heart attack risk.
