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heart failure with low ef

victortejwani profile image

Hi all

I am fairly new here. I have heart failure with LAD and RCA 100% blocked. My echo yesterday shows 35% ef. I am extremely worried and have no idea how to go forward. Any replies will be welcome. Thank you.

24 Replies

I hope you dont mind but Im copying and posting my reply from another poster who asked similar question. I will add to yours that I have seen EF’s improve even though docs dont talk about it much. Biggest thing is to think of your heart as the muscle that it is. It needs a good healthy diet, avoid highly salted foods, exercise, rest. Be hopeful.

I do not have heart failure( yet) but am 67 and have a fib. As a retired nurse, I can say that most times heart failure can be managed for many many years. The heart is a muscle and as we age, it can weaken. It is important to have an exercise program, walking is good. They say walk at a rate that you can carry on a conversation and not let yourself get too winded. Also the docs probably will talk to you about diet, avoiding highly salted foods will help prevent fluid retention. Of course, get plenty of sleep at night. Some people need to raise the head of their bed to breath better or add a pillow if you need.

Mostly, it isnt necessarily an ominous sign. I hate the word heart failure. Failure is a strong negative word. Our eye sight or hearing often gets worse with age but we dont say eye or ear failure. Live your life. If you are a smoker or big alcohol drinker, quit. Sorry this is so long. Us old nurses like to get on our soapboxes😂😂

victortejwani profile image
victortejwani in reply to

Thank you Hoski. It helps a great deal to hear from people who are having the same sort of experience.

I am 69 years old. Had my first heart attack about 35 years ago and recovered from it well. Last october it was found that both my arteries LAD and Rca were completely blocked. I had my second HA in January this year which resulted in heart failure with ef of 35%. Is my ef very low? Is my heart failure very serious. Having looked on google has been very worrying. I think I have a death sentence and not long to live. Thank you all.

in reply to victortejwani

Ive had lots of my patients live many years with EF low. Im no cardiac nurse so I hesitate to comment re life expectancy. The severety of the failure isnt just measured by EF. There are also blood tests heart docs look at. One( here in the US) there is a BNP that is very telling

I copied this from Harvard article:

BNP in congestive heart failure

“It sounds like alphabet soup, but it's actually modern cardiology at its best. BNP helps the body compensate for congestive heart failure (CHF); measurements of BNP help doctors diagnose and treat this serious condition.

Congestive heart failure results when the heart muscle is weakened. The most common causes are coronary artery disease and hypertension. In other cases, heart valve disease is to blame. Less often, various heart muscle diseases (cardiomyopathies) are responsible; in men, their chief causes include viral infections, alcohol abuse, excessively high iron levels, and certain genetic disorders.

The heart's job is to collect blood from the veins, then pump it through the arteries to all the body's tissues. In CHF, the weakened pump is not up to the task; the tissues don't get all the oxygen-rich blood they need, and blood backs up in the lungs and then the veins.

The lack of sufficient tissue oxygen makes people with congestive heart failure feel weak and tired. Muscle function suffers, making it hard to get around. Kidney function is also impaired, sometimes permanently, adding to the fatigue and complicating treatment. Deprived of its full complement of blood, the brain can slow down along with the rest of the body, producing lethargy, confusion, and even grogginess.”

One thing I know for sure, our hearts listen to what our minds say, so positive outlook, manage anxiety/ stress etc is important. Knowledge is power. Ask your docs how severe your condition is but also know, people often make docs look stupid when 5 or 10 yr later they are still thriving with “ a terminal condition”

Be that person. 💜

victortejwani profile image
victortejwani in reply to

Thank you so much Hoski. This is all new to me and you seem to know a lot about it. I am on lot of medication including entresto. Does entresto improve ef and help with heart failure. Is there any cure for hf? Even though i have 100% blocked 2 arteries can they do bypass surgery to create 2 new arteries. Do you know of many patients who lived for 10 years or more with hf and very low ef. It is good to hear from you. Thanks again

in reply to victortejwani

Yes I know patients who have lived 10 yr with low EF. Entresto is supposed to help the heart work better. The other questions re blocked arteries you will need to ask your doctor about. Keep us posted on your progress

victortejwani profile image
victortejwani in reply to

Thanks for all this Hoski. I have a telephone consultation with my consultant tomorrow morning. What do you think i should ask him.

in reply to victortejwani

Write down the same things you asked me. If it was me, I might ask how bad is it? Can I get better? How long do you think I will live? Can my blocked arteries be fixed? What can I do to help myself? What diet should I follow? What kind and how much exercise do I need? What should I not do?

Id be curious to learn what he says, if you dont mind getting back with us here?

Try not to worry I think you have done well may I ask was your heart. Damaged my gp said it’s not the number of the ef it’s how u feel

Best regards

I hope you are still watching these boards. After your second heart attack did you need stenting or CABG ???

I can speak from personal experience that my EF did improve. At one time I was at 20, but as of a few week ago, it is now at 35. I do hope to get that number higher. As Hoski said, follow a good diet and exercise. It is good advise. I am hopeful that the EF will improve further.

in reply to aika

That is amazing!

Hi there

You've written a few posts here about 'heart failure' and are obviously concerned for your health. I wouldn't get hung up on the term, as it's not a death sentence. But we can't advise you on a way forward. Only your cardiology team knows your heart and what treatment is best for it. If there's further treatment, they will advise you of this.

All the best.

Hi, I was diagnosed with heart failure about 18 months ago with an EF in the low to mid 30s. It's a horrible term, unnecessarily distressing. It knocked me sideways, I thought 'that's it the end' but it turns out that's far from the truth! With medication and few life style changes my heart failure is now considered borderline and my EF just before Christmaswas up to 50, just below the normal range. So, it has not only stablised but improved. It can get better, can be managed and you can carrying on living well . Very best wishes

in reply to GracieOS

That is so exciting! Thanks for sharing that

Yasyass profile image
Yasyass in reply to GracieOS

Glad u improving but wh caused your ef to go low

GracieOS profile image
GracieOS in reply to Yasyass

I've had every test going and no definite cause has been found. I have had a small silent heart attack in the past, identified by scaring on the heart, but my Cardiologist doesn't think that's the cause. I have regular ectopics beats, often every third beat, so now the thinking is that maybe the ectopics are contributing to, if not causing, the heart failure. By a process of elimination my Cardiologist thinks it is possible that the medication I was on for rheumatoid arthritis might of been the cause. I came off that medication and things improved heart wise, but on the downside I had a massive flare up of rheumatoid arthritis during lockdown, and was unable to access timely treatment. This left me virtually bed bound and in very significant pain. My quality of life was too low to continue without medication for my arthritis. I'm currently on emergency steriods. Some new medication will be introduced soon but it will need to be supplemented with the old one in time. I've just had an echocardiogram, yesterday, and the news from that is really good, EF around 58%. So that will be the benchmark now to see what impact the arthritis medication has.

It is worth saying that I'm also on a usual heart failure cocktail of drugs, candestartan, bisoperol and a diuretic. It is possible the improvement is down to these as well as, or instead of, coming off methotrexate?

Yasyass profile image
Yasyass in reply to GracieOS

Thank you for your reply glad u are improving

My husband had a heart attack in 1999.

His ejection factor then was 40%.

He’s just turned 85 and for the past 10 years it’s ranged between 28-30% and while he has slowed down so have I-that’s what aging does to all is us.

Having a low EF is not a death sentence at all and the term “heart failure” is pretty frightening.

Be assured if you follow your doctors recommendations, eat healthy, exercise regularly you have many years ahead of you.

The one regret I have in looking back was fear. There is no easy way to overcome it without admitting it and realizing that it’s taking up living as normal and joyous life as we can.

Yasyass profile image
Yasyass in reply to not2worry

I glad to hear something nice I but after the ha was his heart damaged because my gp recommends a icd I was thinking if I could manage without one just with diet exercise

not2worry profile image
not2worry in reply to Yasyass

His heart did have some damage at the time of the HA. But CAD can’t be eliminated just controlled or slowed down. He got his ICD 18 years after the HA and it has improved his quality of life immensely. The day after his ICD implant he got up the next morning and said “WOW, I feel great”.

All the Best From Across the Pond

Hello not 2worry

it is good to hear from you and thank you for joining in with your post. In my case ef is 35% and my left ventricle is moderately impaired. Both my arteries LAd and RCA are 100% blocked and nothing can be done to rectify them. I had my first HA in 1985 and the second one in January this year. It is reassuring what you say but am very worried and anxious.


It very scary to be diagnosed with AF (heart failure),

I was diagnosed with AF February 2019, I was extremely poorly, though I had a chest infection which had been going on for weeks!!. I had a severe chest infection and a lot of fluid around my lung (even though numerous trips to the doctor to keep being told my chest and lungs were clear even though I could not breath or lie down to sleep!!) This diagnoses was totally out of the blue and totally unexpected. Test after test, you name it i had it. Had a procedure that has put my heart back in natural rhythm (and it's stayed that way up to now). The doctor/consultant etc were extremely concern as I was only 60 years old and for someone my age to have an EF of 15% is very unusual. They couldn't understand why this was. Long story short, after Cardiac rehabilitation/exercise classes (which were a great help) and frequent visits to hospital and Cardiac nurse appointments/check ups and medication (oh the medication) my EF is now 55% which is classed as normal (top athletes EF would be around 65%, the consultant informed me no one's heart functions at 100% .

There is life after being informed you have a heart condition.

Good luck with it all.

Serendipity47 profile image
Serendipity47 in reply to Prothy

Totally agree about the use of % for EF being misleading. If you’re told you have an EF of 50% you naturally think you’re heart is only working at half capacity, which is totally not the case, whereas 65%+ is considered pretty normal. My brother, recently diagnosed with HF, only has 12% EF at the age if 54, so reading these posts give us hope for his future.

TRST profile image
TRST in reply to Serendipity47

I am sorry to hear about your brother. I hope meds and whatever else the cardio team can do for him make him feel much better soon.

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