DCM with LVEF 33%

[Vivi2711]

Having been diagnosed with DCM since May 2018 administered with carvedilol 3.125 mg twice daily, spironolactone plus toresemide 10 mg once daily, losartan with potassium 25 mg once daily, atorovastatin 10 mg once daily, clopidegril 75 mg & once daily. On half salt and 1 litre of fluid intake daily with abstinence from alcohol from May 2018. Was a smoker before 4 years. My LVEF at the time of diagnosing DCM was 39%. For a period of six months suffered from shortness of breadth, severe fatigue, loss of appetite, constipation and depression. Walking for 30 minutes daily. From December 2018 all my symptoms had gone but continuing with the medications. On review my LVEF is 33%. For more than 10 days occasional PND is witnessed. Kindly advise me the further course of action

[Fortepiano]

If you want a professional medical opinion from the BHF nurses you need to tag your post - we are just patients! I suggest phoning the nurse helpline.

I assume by PND you mean Paroxysmal Nocturnal Dyspnea - that you are waking up at night with difficulty breathing. My husband had DCM and had this periodically, caused by fluid overload. Do you weigh yourself daily?

The response from his team was centred on getting him down to his dry weight ( no salt!) and optimising his heart failure drugs.

Looking at your post your medications seem rather low - normally it's recommended to titrate medications up to the doses used in heart failure trials - e.g. Carvedilol 25mg twice a day ( 50 mg twice a day if over 85kg). Your losartan dose is also a very low one. If your EF is now down to 33 you may also be eligible for Entresto.

So I would suggest talking to your heart failure consultant about optimising your medications and also asking if cardiac resynchronisation therapy might be helpful. There's often something more that can be done, and these may be avenues worth exploring with your consultant, but do also phone the BHF nurses.

All the best

[Vivi2711 in reply to Fortepiano]

Thanks a lot mam