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Old 01-16-2007, 12:16 AM   #1
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can ejection fraction(LVEF)be improved?

My mother, 68 years just suffered an episode of heart failure. Her LVEF has fallen from 34% to 30% during this episode. Are there any ways/surgery to improve the heart's pumping power.
She has undergone angioplasty and has 2 medicated stents for her blockages which are working fine. She suffered a heart attack 9 years ago but leads an active life.
Thanks for any inputs,

 
Old 01-16-2007, 09:21 AM   #2
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Re: can ejection fraction(LVEF)be improved?

Hi sujkap,

I was dx with heart failure 3 years ago, and my EF was below 29%.

How well one can improve depends on the underlying problem. With a heart attack (MI), there almost always is heart muscle damage, and depending on the extent and location, and how quickly the treatment, would be the factors for the degree of recovery.

There is medication to increase contractions. Usually there is an enlarged left ventricle as a factor in heart failure. I was not prescribed for stronger contraction medication until my heart size returned to normal with other medication.

 
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Old 01-16-2007, 11:31 AM   #3
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Re: can ejection fraction(LVEF)be improved?

Hi Ken im new here. Were you diagnosed with HF or cardiomyopathy?
Did they have any idea what caused it? and are you back to "normal" now?
Sorry for the barrage of questions I havent mustered enough courage to post but have been trolling for a few weeks since my initial diagnosis of cardiomyopathy...
Will

 
Old 01-16-2007, 05:40 PM   #4
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Re: can ejection fraction(LVEF)be improved?

Hi wlassalle,

About 3 years ago I was admitted as an emergency patient with pulmonary edema (I inhaled much dust while working on a home project and that may have triggered the edema!?). Tests indicated I had had a heart attack sometime prior without my knowledge (no symptoms until congestion). I had/have a completely blocked LAD and the RCA artery was stented.

The left ventricle was enlarged (dilated cardiomyopathy), and there was severe mitral valve regurgitation.

Apparently, the cause for the LV enlargement was due (the inhalation of dust aside) to the heart compensating to help overcome the high resistance of vessels, the lower than normal cardiac output due to the regurgitation, and some heart wall impairment at the distal end of the heart.

Medication has lowered the heart workload by dilating vessels, reducing heart rate, reducing body fluids, and increase heart contractions. With time the recent echo shows my heart to be normal in size, pumping efficiency is normal, and my mitral valve regurgitation is moderate. The wall motion impairment does not appear to be an issue.

I am fortunate as I tolerate medication well, and there isn't any noticable side effects. Exercise, eat properly, etc. also is a factor.

 
Old 01-17-2007, 07:46 AM   #5
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Re: can ejection fraction(LVEF)be improved?

Thats awesome KenKeith,
what type of medicine did they have you on and what kind of diet/exercise do you reccomend?
Thanks!
Will

 
Old 01-17-2007, 10:38 AM   #6
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Re: can ejection fraction(LVEF)be improved?

Will,

Lisinopril (ACE inhibitor) to dilate vessels, Coreg (beta blocker) to maintain a slower heart rate and help dilate vessels, Digitek for stronger heart contractions, Furosemide as a diuretic, and Isosorbide that targets the coronary arteries to dilate specifically (expected to relieve any angina).

My cholesterol and weight has always been OK, but I continue to eat fish, chicken, occasionally beef, vegetables and fruit, etc.

For an aerobic exercise, walking briskly on the treadmill for about 30 minutes 3X a week, as well as resistance training equipment exercising. It is a continuation that I have been doing for a very long time.

 
Old 01-17-2007, 10:57 AM   #7
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Re: can ejection fraction(LVEF)be improved?

Thanks for your answers KenKeith,
So have doctors said you are no longer in heart failure?
what is your EF now?
I go for a follow up after all the tests they did on me in the hospital 2 weeks ago tomorow. I am soooo scared.
Thanks again!
Will

 
Old 01-17-2007, 04:07 PM   #8
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Re: can ejection fraction(LVEF)be improved?

Heart failure is an EF below 29% (amout pumped out with each stroke) My EF is around 59% with meds so the heart isn't failing, but some blood goes back into the atrium, so the amount that goes into circulation is less than 59%.

 
Old 01-17-2007, 09:19 PM   #9
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Re: can ejection fraction(LVEF)be improved?

thanks for inputs. been reading all and more. mom is overweight, will have her shed some wt. yes, heart is enlarged, I guess the heart failure was precipitated by high fever and chills brought on by urine infection and developing blood sepsis for which she had to go to emergency. she is also diabetic , type 2 ,on insulin.
I guess diet, wt reduction and exercise, all life style changes shld make the difference

 
Old 01-18-2007, 07:17 AM   #10
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Re: can ejection fraction(LVEF)be improved?

Sorry to be a pain Keith but are you still on those medications now even though your heart size is normal and your EF is 59%?
Thanks!
Will

 
Old 01-18-2007, 09:23 AM   #11
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Re: can ejection fraction(LVEF)be improved?

There is an assumption the heart will not withstand very well a burden of continued resistence from constricted vessels and valve disorder. Stability and consistency of the cardiovascular with medication is a conservative approach.

And as sujkap states proper weight is less burden and exercise increase stronger contractions. Unfortunately, diabetes and some heart medication are contraindicated, and it is sometimes difficult to treat heart patients.

 
Old 01-19-2007, 01:50 PM   #12
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Re: can ejection fraction(LVEF)be improved?

KK,
Let me amplify Lassalle's question.
Does it tempt you to decrease your meds in response to your much improved situation?
Quote:
Lisinopril (ACE inhibitor) to dilate vessels, Coreg (beta blocker) to maintain a slower heart rate and help dilate vessels, Digitek for stronger heart contractions, Furosemide as a diuretic, and Isosorbide that targets the coronary arteries to dilate specifically (expected to relieve any angina).

I must presume from passt posts that you add aspirin and Plavix to that regimen.
That's a LOT of meds.
Any thoughts on cutting back?

Please clear something up for me. Though your name is KenKeith, presumably MALE, I have always picked up a feminine vibe, or post, or SOMETHING. Do I have the wrong end of the stick?

<Maybe I have a preoccupatiion with PENELOPE KEITH!>

Last edited by Lenin; 01-19-2007 at 01:55 PM.

 
Old 01-21-2007, 04:32 PM   #13
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Re: can ejection fraction(LVEF)be improved?

Quote:
I must presume from passt posts that you add aspirin and Plavix to that regimen.
That's a LOT of meds.
Any thoughts on cutting back?
Lenin:

I took Plavix for 10 months subsequent to stent implant going on 3 years ago. It is correct I take aspirin (coated) daily as well as multi-vitamins (I don't believe that relates much to heart failure medication, more for stroke and clots).

I had thought of discontinuing Furosemide and take only when there appears to be water retention (a fast 3 lb. gain overnight) for instance. I don't or at least didn't have angina (could be there is a prevention with the drug) , nevertheless, the doc prescribed isosormide. I am going to ask doc for something in the event of angina, apparently there could be a problem and no angina, and then silent HF. I don't know.

You assumed correctly. I am male and no relation to Penelope, my middle name is Keith. You are going to have to get out more and stop dreaming.

I googled Penelope Keith to see what you were talking about. I googled KenKeith (me) and there are many hits for me as a participating "computer geek" (acquired status) member with several computer forums. Until 3 years ago I participated for several years with BBS and several computer forums helping people with computer hardware and software problems. That may have confused you!

Last edited by started04; 01-21-2007 at 06:07 PM.

 
Old 01-21-2007, 11:51 PM   #14
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Re: can ejection fraction(LVEF)be improved?

QUOTE: Lenin, Please clear something up for me. Though your name is KenKeith, presumably MALE, I have always picked up a feminine vibe, or post, or SOMETHING. Do I have the wrong end of the stick?

Oh! Now I know. You are referring to a post where I was assumed to be Donald Trump and you are Rosie. It was a joke!

I don't have it, but my sister has a Master's degree in English and writes poetry and has an artistic flair in her writing. You have an artistic tilt and some creativity in many of your posts, but that doesn't imply femininity!

My mother wanted a girl so I was named Ken Keith! Similar to Johnny Cash being named Sue!

 
Old 01-23-2007, 07:06 PM   #15
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Re: can ejection fraction(LVEF)be improved?

Sujkap,
Your mother sounds somewhat similar to my dad. He was first diagnosed w/ CHF about two years ago, age 64. He is also diabetic and on insulin and glucophage. His heart was enlarged and the muscle very damaged. He is only alive today because he now has pacemaker (with debibrillator).

He was not a suitable candidate for heart repair or replacement and was told he might live anywhere from a few months to "maybe as long as" three years. It was not until his third time in the hospital for CHF that anyone, including his cardiologist, even mentioned the idea of a pacemaker. Apparently the patient has to meet certain critera, be at a certain "stage" of heart failure, to qualify for one. I do not recall now the specifics, but it might be something worth asking your mother's doctors about.

The pacemaker is not perfect; he still has occasional difficulties from various heart issues, and the device has to be "tuned up" on a regular basis. He also had to learn to be aware of problems symptoms, something that was clearly demonstrated when his pacemaker battery died prematurely between checkups. (It is supposed to sound a beeping alarm, but that "died", too.)

In the months leading up to the surgery, he was so lethargic and depressed and mentally confused that I was about to put him into a care facility, but he literally came out of the pacemaker surgery a new man.

Again, for a variety of reason, I do not know if this is even a possibility for your mother, but it may be something at least worth looking into. Good luck.

 
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