PVC's and reduced EF

[Scott927]

I'm a 38 year old male.  I've never had any serious health issues until, in fact, I used to be a distance runner.  The last few months I started noticing a slight fluttering effect in my upper left heart.  I wasn't really too concerned, but as a father to a 3 year old, I felt I needed to get it checked out.  I went to my MD who did blood tests and an eeg.  The eeg showed that I had PVC's but he didn't seem really that concerned about those.  He did notice that my red bllod count was high so he sent me to an oncologist.  The oncologist suspected I might have hemachromtosis or polycythemia which are diseases that cause an over production of red blood cells which can cause your blood to thicken if not treated.  I also had slight high blood pressure and a pulse rate that normally runs 90-100 bpm.  The red count was high , but not so high that I required any meds or anything.  My oncologist decided to send me to a heart specialist for an echo just to make sure my heart didn't have a hole which often can cause high red count.  I didn't hear anything after my echo until 6 weeks later when I went back to my oncologist.  He told me he had been trying to reach me because my ef was between 20-30% which indicated heart failure.  I was floored.  I am not in the best of shape (I've put on some weight and haven't trained for years) but otherwise I am healthy.  I don't suffer shortness of breath, chest pain (other than the flutter) or any other symptom for heart failure.  I have to go back to the cardiologist next week, but to be honest with you, I am scared to death.  I have had no other info, other than what I have read online.  From what I have seen with an EF that low, I am in dire need of heart surgery.  I guess what I am wondering is if anyone else has had an experience like me (no real symptoms other than PVC's)?  Also, does anyone know if the echo could have been wrong or if the PVC's could have had an affect on the echo.  I guess I am looking for any positive news.  I want to see my son grow up but from all I have read, it doesn't look good.  Any words of advice out there?

[kenkeith]

QUOTE:  "He also said that since I used to be a distance runner, my EF may not need to be as high for me to function well and that what was most important was how I felt".

Your doctor makes a good point.  It is estimated about 26% of the heart disorder populatioin do not know they have an EF below 29% (heart failure range).  A cardiologist will also state that some patients with a lower EF feel better than a patient within the normal range of 55 to 75%.  


Some individuals compensate well, and apparently you are in that category.

[Scott927]

I'm glad to hear that much of your symptoms have been relieved.  I know the MVR is worrisome, but it sounds to me like you had great care.  I certainly wish you the best and hope you continue to improve.

As far as my case goes, I finally got to see my cardiologist today after a nearly 3 hour wait.  I was shocked at how many people were waiting.

I was diagnosed with idiopathic cardiomyopathy and benign hypertension.  He said that since I feel fine and I am active that I shouldn't worry so much about my EF.  He said it could have been a virus, or it could be genetics (since I have had some people in my family who have had issues with heart disease) or it could have been something totally unknown.  He also said that since I used to be a distance runner, my EF may not need to be as high for me to function well and that what was most important was how I felt.

He advised me to keep exercising, lose a few pounds and watch the salt.  He also  prescribed a low dose of coreg cr.  I have to go back in 6 months for another echo and if my EF has held steady (or hopefully improved) then he said the prognosis was very good.  I guess I am not out of the woods yet, but I am encouraged by what he told me. I feel like I have caught this before it got too bad so I plan to do everything I can to improve my condition.


I appreciate your sharing KenKeith.  I will say a prayer for you.

[kenkeith]

CHF occurred after I had carelessly worked on a home project in a dusty environment for several hours.  I went to ER due to hyperventalating, dry cough, shortness of breath (all symptoms of edema), as well as a fast heart rate for two nights while trying to sleep.  Thought it was a lung problem and was shocked to hear I had congested heart failure.  Considered myself to relatively healthy, correct weight and diet, no family history, etc.

An echo showed I had hypokinesis (heart muscle impairment) and ischemia (lack of oxygenated blood) caused by some artery blockage.  Hypokinesis resulted in low EF, overworked heart caused enlarged left ventricle (enlarged LV was thought to have caused mitral valve regurgitation.

Treatment was to stent RCA (98%) blocked, medication (ACE inhibitor) to dilate vessels to reduce heart workload as well as beta blocker, diuretic for edema (6 months), anti-platelets meds, digitek to increase heart contractions.  

Medication reversed the remodeled left ventricle. Stent and medication provided more oxygenated blood to the hypokinetic location of the heart, etc.  A subsequent echo showed LV EF to be normal and no heart muscle impairment of any significance, but MVR did not improve.

I was also told the 19% EF must be an error as I would not be able to walk up a flight of stairs with 19% (calculated during cath)?!  

[Scott927]

Thank you for your reply.  I've posted a couple of times on here and you are the first to give me any feedback.  May I ask what caused your ef to be so low?  It's good to hear that it was several years ago.

As far as my problems go, I guess I could understand it more if I had symptoms.  I have no shortness or breath or fatigue (other than normal for a guy my age carrying a few extra pounds).  My cholesterol/triglycerides are fine, my stroke screening at work (echo of carotid, bp at each ankle) came up normal with no build up or blockage.  My heart rate runs a bit high sometimes (90-100 bpm) and I occassionally have slightly high bp, but I was told all of that was caused by the high red count which causes your blood to thicken a bit.  Other than the PVC's and the slight butterfly feeling in my left chest, I feel fine.  From what I have read other places, with an ef that low, I shouldn't be able to walk up a flight of stairs without being winded.

Did you have any other symptioms besides the edema?  May I ask what your course of treatment has been?  Any advice you can give me would be great.

[kenkeith]

It is not uncommon for an individual to learn of a heart problem while being treated or dx for another condition.

It has been many years now, but I experienced heart failure and a low EF (19-29%).  I didn't know I had a heart condition until I had symptoms of heart failure.  Heart failure caused fluids to leak into the lungs (edema).  It is estimated there is 26% of the heart problem population do not know they have heart failure (EF below 29%).  Unfortunately there are are no symptoms and without treatment there eventually could be a heart attack (MI).

When there is a low EF, the echo is able to show impairment of the heart wall movements in real time.  You may not need heart surgery depending on the underlying cause.  Without symptoms and further information, it is difficult to determine the underlying cause.  It could be due to an enlarged left ventricle, valve insufficiency, damaged heart muscle from medication, viral, drugs,alcohol, blocked vessels, congenital malformation, etc.

An enlarged left ventricle can cause arrhythmia.  An arrhythmia can provide an inconclusive test if there is an episode during the test.