Low Ejection Fraction

I am a 50 year old female, 128 pounds, 5'5", used to be very energetic but not much any more. Can a person have a pacemaker (AV Node ablation, 3rd degree heart block), low ejection fraction (40%), mitral and tricuspid valve regurgitation (mild to moderate), taking diuretics because of fluid, Wolff Parkinson's White syndrome and palpitations (I think I'm done), and still not have heart failure? They found the low EF and the valve problems with an echo about a month ago but never told me that I had heart failure, just put me on meds for the fluids and a week later done a blood test (BUN) and told me when the results came in that I need to stay on the meds. I am due for another ablation for the WPW in May. Does anyone know if they will fix or repair my valves or will leave them like they are? I'm not scheduled to see my cardiologist until the first of May (before my ablation with my EP). Even if my EF gets better, does that mean that my valves are better? I don't really understand all of this? I would appreciate any help.

Pacie

4 Comments

Heart Failure

by SMITTY - 2009-03-24 08:03:43


Hello Pacie,

I think it is safe to say you have heart failure, but that is not to say you have been given a death sentence. We can have heart failure due to many different reasons and you certainly named a lot of those reasons in the list of your heart ailments. However, with treatment of these problems and you striving to take care of your body in general you can enjoy many years of joyful living.

As for fixing some of your problems lets start with the leaking valve. An echo can show a valve that has a leak too small to be of much concern, For example my wife has had a leaky valve since she was 9 years old (she will be 80 in a few months) and has refused to have it repaired any number of times because it does not limit her activities. I have congestive heart failure which was diagnosed in 1987 and while it has gotten a little worse over the years age it has not slowed me down enough to make much difference in my life. So ask your doctor how bad is your leaky valve?

I would like to add a comment to what Patch said about ejection fraction (EF) being measured in %. Patch, everything has to be called something. Seriously, they hung percent on EF to describe the levels of seriousness. Patch you know I'm kidding you and I'm sure you know this so I'm saying it for those that may not. EF is measured in percent because that is a very easy way to state the amount of blood being pumped each beat by our heart.

For example, a normal size heart contains about 200 CC of blood, Saying that someone has an EF of 60% (55% to 65% is a normal EF) is an easy way of saying their heart is pumping about 120 CC of blood each beat. So in your case (and mine too incidentally) saying we have an ejection fraction or 40% sounds almost deathly. However, what it is really saying is that our heart is pumping about 80 cc of blood each beat. That 80 CC is actually 67% of the amount of blood that a normal heart would pump each beat. From what I have been told that is enough blood flow to sustain a comfortable lifestyle so long as we don't do anything too strenuous. In addition there are now pacemakers with an additional lead to improve our EF. And if we have a low EF physical activity that is too strenuous usually makes itself known by shortness of breath.

But that is enough from me. I say follow your doctor's orders, take those meds, eat a heart heathy diet, exercise regularly and don't worry about having heart failure. We all have heart failure, just some of us have it to a greater degree than others.

Good luck,

Smitty

Thank you so much...

by pacie - 2009-03-24 10:03:49

Both, Cabg Patch and Smitty, have made me feel so much better. Thank you for the responses. Smitty, do you still have to take diuretics or has yours gotten so much better that they have taken you off of them? Or do we EVER get off of them? Can I still drink regularly or do I need to watch how much I drink? Sorry for all of the questions.

Pacie

Diurectics

by SMITTY - 2009-03-25 02:03:44

Hi Pacie,

Yes I still take diuretics. Of course I've been taking them on a regular basis for some 40+ years. I started out taking them to help with high blood pressure. I've been on many different ones, but am presently on Lasix.

Since Lasix is not very accommodating, by that I mean I take it and it will get my undivided attention for a few hours. I do not take it every day. However I never skip more than two days and I carefully watch for signs of fluid retention such as swelling around my ankles or in my hands.

As for drinking while taking diuretics, yes I have. I have consumed about any alcoholic beverage in what ever quality you can think of, except beer, since long before starting the diuretics. I don't drink beer simply because I have never liked the taste. I drink very little of anything now. A bourbon highball a few times a year, a year maybe. (all my drinking buddies have moved away or died)

The truth is I made the drastic cut in the amount alcohol I consume when I learned that alcohol was a major contributor to the my high triglyceride levels. I was taking cholesterol meds and getting good numbers on total cholesterol and good and bad cholesterol levels and was puzzled about my high triglyceride readings. Then I learned that my cholesterol meds didn't do much toward lowering the triglycires, but and sugar, especailly the sugar the body makes fro alcohol was the culprit. So, I reduced my sugar and alcohol intake and stop the alcohol completely for at least 48 to 72 hrs prior to a blood test. Seems to work for me as the triglycliceride numbers are down to acceptable levels now.

One last word about alcohol and diuretics. It has been my experience that there is no better way to jump start the action of a diurectic than to take one followed by a ounce or two of alcohol. I will cautionyou or anyone that may try this, but take the diuretic (any kind) wait 15 to 20 minutes and then down an ounce of alcohol, any kind. Just be sure a potty is handy because diuretics followed by alcohol wait for no one.

Smitty

Oh wait, Smitty

by pacie - 2009-03-27 05:03:21

Hi Smitty:

I meant drinking fluids in general, water, tea, kool-aide, Diet Coke. I haven't touched any alcohol in years! Sorry for the mistake, I need to make myself more clear. Thanks for the advice anyway.

Pacie

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I've seen many posts about people being concerned about exercise after having a device so thought I would let you know that yesterday I raced my first marathon since having my pacemaker fitted in fall 2004.