Ejection fraction low

[Giantpanda1]

Hello does anyone advise on improving a low ejection fraction? I have a healthy diet and have never smoked and as was quite fit up until now

[Giantpanda1]

No proper diagnosis other than moderate mitral valve prolapse, enlarged heart, heavily trabeculation ,unsure as to cause, possible lvnc .32%

[Giantpanda1]

Yes slight swelling and short of breath .

[Mark_tourguide]

Hello Giantpanda1,

I also have MVP and ( I think) EF and mitral regurgitation too (!) and I think it all relates to the same thing, which essentially means a ‘healthy lifestyle’, moderate exercise, and monitoring the symptoms until they become intolerable! At which point an operation would likely be proposed.

It all sounds a bit gloomy, but I suppose it could be much worse...👨

Would be interested in the take of anyone else on this and any further reading/ videos which might help 😌.

Thks

M

[Giantpanda1 in reply to Mark_tourguide]

Thanks for reply. I wish it was simple as changing diet ...that would be easy as already eat very healthily! All a bit mysterious as to cause.

[Smileyian in reply to Giantpanda1]

My LVEF has considerably improved in 2 years. Had an Echo result last week which was essentially "normal" but a good LVEF of 65 which I was told is very good for a 77 year old. I have been diagnosed with Prinzmetals.

[Paperlover in reply to Mark_tourguide]

I had a “severe” mitral valve prolapse and AF. I’d also apparently had a silent stroke. However, I never had any symptoms and it was all picked up when I went to see the GP about something else. At the time I was going to gym classes 5 times a week, including a fairly intense spin class. I could run 5k in just over 30 minutes which isn’t fast, but not bad for my age. My cardiologist arranged for a treadmill/vo2 max test because he had a new member of staff able to analyse and manage everything! When he referred me to the surgeon for an opinion his letter said the results were better than expected. Despite this I got a call from the surgeon who said even without symptoms, I met the criteria for surgery. He said my prolapse was so bad, if I hadn’t been so fit, I wouldn’t have been able to get dressed in the morning without being breathless. I had my valve repaired and an ablation and a couple of things last October. So it’s not just about symptoms it’s about whether you meet the criteria which I assume are laid out somewhere in NICE guidelines, and whether you have a good cardiologist and surgeon. I’m lucky to live near Sheffield where they have a specialist minimally invasive surgery team so the waiting lists aren’t too long. I think it’s worth doing some research on criteria and also finding out some key info about how much regurgitation there is etc. Then you could ask a surgeon for an opinion.

[Mark_tourguide in reply to Paperlover]

Thanks that’s very helpful. I found out about the MVP because of a stroke too. The specialist’s take is that whilst the regurgitation is moderate/severe surgery is not currently to be recommended as I’m ‘only’ 56 (‘and currently asymptotic)but that I will probably need ‘the op’ within the next ten years. There is a big part of me that would like to just have it done sooner rather than later though, and although your situation sounds like it was rather more serious than mine, I imagine much you can function much as before but without the danger? Was the procedure very difficult or were you just relieved to have it?!

[Paperlover in reply to Mark_tourguide]

I was in exactly your position. I was 55 when my cardiologist said I would need an operation later but not yet. I was keen to get it sorted sooner rather than later and didn’t relish the idea of open heart surgery in my 60s. Having been monitored for a couple of years including an unpleasant but information rich trans oesophageal echo I knew it was on the more severe side but was reassured that I was in no great danger of a heart attack and they were keeping an eye on the size of my left ventricle. I had a TIA in Jan 2020, then had the stress test in Feb, though that had been promised in Oct 19, and then Covid meant I couldn’t go and see him for the results. Instead he sent them to a surgeon for an opinion in April and I got a call in June saying that I could go ahead if I wanted and it would definitely be before Christmas. There was a delay because I needed an angiogram at a different hospital but I had my op in early Oct. The operation itself wasn’t too bad. I remember very little and was back home in 4 days with no pain. After a few weeks I had a recurring problem with an infection in the site of the camera port so my recovery hasn’t been the best, and also the gyms are closed so I don’t really know whether I’m back to normal yet. I’ve tried doing exercises at home but it’s just boring! I’m having my camera site opened up and flushed in a couple of weeks and then I hope to be back on my fitness regime. What I can say is that if I do exactly the same bike ride now as I did pre-op, my heart rate stays very firmly in my Fitbit fat burn zone rather than at the upper end of my cardio zone or even peak. I assume this is because my heart isn’t working as hard! Not quite sure why my resting heart rate is now around 68 instead of 55 but the surgeon did say it can take up to a year for that to settle down after they’ve been playing around in the heart and it’s within the normal range so I’m happy. I think if I hadn’t had the infection I’d have been pretty much ok within 4 weeks and gradually built up to exercising after Christmas. I think you need a conversation with your cardiologist to explain how you’re feeling, then he can go through all the stats and explain why he’s saying not yet.

[Mark_tourguide in reply to Paperlover]

Thanks - really helpful. 🙂

[Farmer87]

Ooo my mitral valve is moderate to, I've had it 13 years I think or 15 I can't remember lol.Like I have good days and bad days, mine causes a lot of extra or premature beats which I'm now taking beta blockers for (post on here because I was to scared to take them) I know that when the blood flows back this can irritate the heart and cause some palpitations.

Anyway my lifestyle is pretty much:

Don't drink alcohol anymore, don't smoke I did years ago, don't eat anything with too much sugar like 1 or 2 treats a day like a Mars bar or small cake, drink only decaf tea so nothing caffeinated which can be a pain as some places don't do decaf yet. Cut out fizzy drinks, definitely try and sleep 8 hours a night, I only walk a lot now I used to bike and skate until I was on beta blockers. I pretty much eat veg everyday and drink pure oj for the vitamins etc. It's just managing to get the right balance of everything.

I walked around cheddar gorge that really took it out of me up some of them hills and had the heart going well and breathlessness.

I Spoke to my cardiologist yesterday and he said until your proper breathless we won't operate.

If you want to know anymore feel free to pm me or anyone else. Always willing to help and talk.

[Giantpanda1 in reply to Farmer87]

Thanks for reply. I guess I could cut all alcohol out to help.

[Farmer87 in reply to Giantpanda1]

Alcohol makes a huge difference, I lost a lot of weight to when I stopped drinking.

[RufusScamp in reply to Farmer87]

That's a lot of sugar, especially with the orange juice.

[Farmer87 in reply to RufusScamp]

I only have 1 glass a day not a pint etc, it's the only sugary thing I have.

[Giantpanda1]

Yes I am, I’m waiting for mri just seems a long wait watching symptoms worsen .

[FeetheBookworm]

There is a diet suggested by BHF in their HF bible. I will have a look online and post a link. I was given a hard copy when I was first diagnosed, when my EF was 17. Once it got up to 43 I was discharged from clinic.

I am overseen by Harefield and they usually see me twice a yr but obviously in lockdown that’s not happened and it’s done over the phone. Am going up soon for a blood test and an ECG halter monitor for 48hrs as been having irregular palpitations.

[FeetheBookworm]

Here is the link to the HF book: bhf.org.uk/~/media/files/pu...

[Giantpanda1 in reply to FeetheBookworm]

Thank you very much

[Giantpanda1]

Iii ask gp to review although I think she is waiting for cardiology to advise following scan I’m waiting for.