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British Heart Foundation
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Reducing Ramipril

Hi everyone.I was diagnosed with left ventricular dysfunction and an Ejection fraction of 37 back in May and told to take Ramipril. I also have LBBB. My ejection fraction has improved to over 50% now and I have been told I may have had Myocarditis virus. My question is have others reduced their Ramipril when their EF gets to normal, I did not have high blood pressure, I have been told I should take Ramipril for life just in case I get symptoms again. But how shall I know if my heart condition is OK now. I guess the LBBB does not need medication if I have no symptoms. All my CT scans are clear so why do the doctors just want to put you on life long medication when you may be OK?

Anyone elses experience of coming off Ramipril would be greatly appreciated

10 Replies
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The reason for maintaining Ramapril despite an increased EF is that it has improved but not been cured. Reducing or withdrawing Ramapril could result in your EF dropping back and would also increase the risk of other cardiac events.

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Thank you for your reply Michael but if I have had myocarditis virus how will I know I am cured unless I reduce my meds before having my next echo? Are you saying that no one is ever cured from a heart event?

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I was primarily referring to the use of Ramapril in the treatment of reduced EF. My knowledge of Myocarditis is extremely limited (I am not medically qualified) but I know it has many causes including viral (like yours), bacterial and health problems like Lupus. In all honesty I think you need to be guided by your GP/cardiologist. Why not call the BHF nurses who will know more than I.

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Thank you again for your reply Michael.

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Hi taraharp. I have same symptoms as you with lbbb and ef of 40. I am on bisoprolol 10mg and ramipril 5mg. Can i ask what dosages you are taking? Thank you.

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Hi Genteel

I started on 2.5 every day then increased to 2.5mg twice a day and now my cardiologist wants to increase to 5 mg twice a day but I was very tired all the time at this dose so want to go back to 2.5 twice a day. I am seeing my cardiologist next week so will tell him. He also wanted me to take beta blockers but I said no.My concern was that the doctors seem to think I will be on drugs for life as they say that the ramipril improves my EF. How will I know if it is me getting better unless I come off or reduce the medication.

Thank you genteel

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Thank you for your reply Taraharp. I think if you can tolerate the ramipril it would be best to stay on it as a part of your daily routine ( there are other medications/ace inhibitors too). I have met people on ramipril after heart attacks and for hf and also my brother in law had a small stroke and they put him on ramipril too as part of his medication precautions as it helps protect the heart. Of course your cardiologist will give you the best advise. Hope all goes well for you.

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Thankyou Genteel. It sounds like pills for life then!

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Hi

I think you have arrived at the point a lot of people with heart conditions have, you are going to be on Medication for Life.

Our normal response to getting a Prescription from our GP is to take the Pills or Medicine for 7/14 days and all will be well i.e. you will be cured from your ailment. With Heart Conditions it's not that simple unfortunately. My understanding is that the Pills for quite a lot of Heart related conditions is, that the Pills help to control the symptoms but not Cure the Problem.

Personally sometimes in the morning I resent the fact that the handful of Dolly Mixtures I am about to take will not fix me and may even make me feel worse, But and it's a big But they are helping to keep me alive for longer than I may have been without them !!

That's why I keep on popping the Pills. Hope that makes some sense.

Regards Frank W

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Thank you for your long reply Frank. I guess I have to do as I'm told for once!

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