Affect of low Ejection Fraction

[Sean L]

Hi had the valve replaced and a pacemaker put in last april. Things seemed to be going well but I have still been tired. Dr. says I still have an Ejection fraction of 35% which they would have thought would have improved more by this time. They are sending me in for more tests, invasive in nature. Has anyone had this problem with the ejection fraction not improving greatly...what happens? what are the options? Thanks,

 

[Ross]

Sean how did they arrive at the 35% conclusion, what test did they do? If they're basing it on an echo, it's probably not accurate.

 

[Sean L]

Thansk for the reply Ross.

It was an echo. They did a cardiac cath prior to surgery and said the EF was 32%. Two months after surgery they did an echo and it was 30%. They did an echo last Dec and it was 35%. Now they are sending me to some specialist in arythmia. Do you know what type of test he will do? My doctor mentioned the possibility of some sort of Biventricular Device.

What is the worst that can happen? will I eventually need a transplant? Thanks for the reply.

 

[lb151]

I have an EF of 35%,, give or take,,this was determined at the time of my valve replacement. I will be going in next month to have an echo and see if it has improved. My doctor and I put more stock in how I am feeling,rather than numbers...shortness of breath,ect. The bi ventricular device he was referring to is probably associated with a bi ventricular pacemaker or ICD. I have one and it helps by giving the venticle an extra push to improve blood flow,putting it simply.That along with meds can improve the hearts function.
Is the specialist an electrophysiologist?

 

[briansmom]

My son's EF is about 40% now. Since his last surgery his has been as low at 27 and as high as 45. They don't even think about a heart transplant unless it is below 30% and you are very symptomatic. As for the effects, it really depends. Some people hardly notice a low ef. My son seems to require extra sleep, it takes him a long time to get over colds and stuff and he is not very physically strong.

 

[abbanabba]

Pre surgery I also had an EF reading of 36%, but all my other tests showed it as mid 40's. Funny thing is, the "other tests" were echos and the 36% was done via MRI which is supposed to be the most accurate, but my cardio thought it was probably a "technical misinterpretation". I haven't had a chance to find out if it's changed much post-op, but I'm certainly feeling better.

I guess you'd have to chat with your cardio about what might happen if it doesn't improve. If it stays stable and you're not having too many issues symptom-wise with it, they may just keep an eye on it.. maybe some medication. Still, I'm sure it's disappointing that things haven't shown more of an improvement. I hope the next round of test come up with some answers for you.


A : )

 

[Debster]

Hey Sean! Right after surgery my mom's EF was around 20-25%. Almost 4 years later it was at last check 54%. She does have a bivent pacemaker, which has helped her big time. She is also on coreg and digoxin as well. I think the drugs helped, but she and I both believe that pacer has been a miracle worker. Best wishes to you.... Deb

 

[Sean L]

Thanks for the replies. It is nice to know that other people have improved. I want to thank Brians mom for the information on heart transplants. That makes me feel reassurred that there is a lot they can do before having to even consider a transplant. Although, for me, it is stressful to not be out of the woods as I am the only one earning an income in the household and have a wife and two small boys.

 

[briansmom]

Brian also has a bi-vent pacemaker which they say usually gives you a 5-10% increase in ef. Brian is also on coreg, lisinopril and lasix. There is a lot that they can do with the pacemaker and meds to keep your heart pumping!

 

[Dina]

Funny thing is, the "other tests" were echos and the 36% was done via MRI which is supposed to be the most accurate, but my cardio thought it was probably a "technical misinterpretation".
A : )

I have also been told to not take the echo stats as exact when dealing
with ejection pressures.When my pulmon HTN was estimated it was off
by 15 when compared the angio.But many here seem to be able to rely
on their echo estimations,so maybe my cardio didn't interpret it well.
When you say you are tired do you mean SOB or fatigued? My problem
is(was) much different from yours and I am still SOB on exertion(DOE),
it seems like we would be different symptomatically,since we are pathologically.
Hope you feel better soon

 

[Sean L]

When I say tired I mean that I am absent minded and feel like I want to sit and do nothing. I am not sure if it is stress at work or my heart. My wife is convinced it is my heart and doesn't believe work stress could give me this many problems. I am not sure I agree with her. All I know is that my ability to run is not where I thought it would be almost 9 mos after the surgery. I could do more exercise 1 week prior to my surgery than I can now.

So I guess they are going to look into it further. I just hope I don't have to get a different pacemaker as it is no fun to go through the process again with the weight of financially supporting my family on my back (in the middle of a recession).

I have a quesion for Brian's mom...how big is the pacemaker brian has?

Thanks,

 

[briansmom]

Hi Sean,
Sorry for the delay. Brian's pacemaker is about 2" x 2.5" x .3". Mind you, this was measuring by him grabbing it in his chest and indicating the sides, so it is probably slightly smaller than what I am giving you.

 

[realkarl]

Sean: I was curious if you got a biventricular pacemaker, and if you did, how did it affect your EF and aerobic capacity?

I am stuck at 40% EF with a left bundle branch block, and at 4 months out, not even at the aerobic capacity I had pre-surgery, and very far from a little over a year ago, before the sudden onset of symptoms. I used to bicycle every day, and can easily compare my (lack of) capacity.

My cardiologist, whose specialty is electrophysiology, strongly recommends such a device for me. From what I read, it can sometimes work wonders. There are risks, of course, but usually a relatively simple outpatient procedure.

Karl.