heart failure

[texas3]

Hi,

Thank you for taking my question!!

I am 38 yrs old and I have been treated for hbp since 18.  I am on 240mg dilacor, 40mg Zestril, and 25mg HCTZ.  

My mother passed away at 56 of a massive heart attack.  

In March I noticed swelling in my chest and feet.  I went to the GP and he sent me to a cardiologist.  I was put on HCTZ and dropped 20lbs overnight (best weight loss ever).  I do get short of breath upon physical activity.  I am also out of shape.

The Dr. did a echo and said I have mild CHF and mild regeritation (I had rehumatic fever as a child).  I don't know what valve it is I go back to him on the 22nd.   He sent me for a thallium stress test and said it was abnormal so I went in for a left sided heart cath.  no blockages.   my ef was 61.  He said that was abnormal for my age????

I was under the impression that a ef over 60 was good?

Is it still possible that I have CHF even though my heart cath was good?

If I do have CHF should I be on a calcium channel blocker?

Thank you so much
Robin

[bigmick]

Hi mate,

My last echo "could not have been any better" according to my cardio/EP. EF was 75%. You'll perhaps remember I'm a big strapping chap at 43yrs young, 6'4" and 225lbs. What dya reckon? Good? Can an AF be TOO high, and if so why??

Yours (neurotically!!),

BM.

[CCF-M.D.-MJM]

Good questions Robin,

I was under the impression that a ef over 60 was good?
An ejection fraction of 60% is normal.  If they told you it was abnormal, you may want to inquire as to what was abnormal about it.

Is it still possible that I have CHF even though my heart cath was good?
Yes.  Rheumatic heart disease causes your heart valves to become tight (stenotic) or leaky (regurgitant).  It sounds like you have a leaky mitral valve.  Over time, ventricular function can deteriorate with stenotic or regurgitant valves. You should be followed closely by a cardiologist.  If the valves continue to worsen, many patients eventually require valvular repair or replacement.

If I do have CHF should I be on a calcium channel blocker?
Another good question.  In general, beta blockers are better for CHF, however, with a leaky mitral valve, sometimes it is better to let rate go faster.  

Make sure you keep following with your cardiologist as directed and if symptoms change.  You may also want to clarify if your mitral valve is stenotic (narrowed).  If you feel like your symptoms are getting worse and are not being addressed, you may want to seek a second opinion.  We see a lot of rheumatic heart disease at the Cleveland Clinic.  If you are close or don't mind the travel, we are a very experienced center.

Good luck and thanks for posting.