I had a mitral valve replacement last year due to regurgitation and then a redo replacement 10 weeks ago due to endocarditis. I had an echo recently and just spoke with a cardiac nurse. She told me that there’s damage to my heart muscle and that my ef was 45%. This was not reassuring and has left me worried sick about what’s coming next
Can anyone tell me if they have heart muscle damage and what an ef of 45% means. Can you live and function even with significant damage and a low ef. ? Can it heal itself? I understand that everyone is individual but it would be great to hear other peoples experiences.
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Anon2023
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Hi. Thank you for your reply. It’s reassuring. I walk every day and don’t particularly get out of breath. I was surprised it was 45% as I’ve felt ok after my surgery 10 weeks ago. I’m 50 and before my heart ops I felt relatively ok so all of this has completely taken me by surprise. I think medical folk forget how frightening this can be and I dread getting a call from the cardiac nurses. They referred me to psychology as the last 6 months have been really traumatic. Let’s hope it helps. Thanks again for your response. I really appreciate it.
I went through similar a couple of years ago, about 18months after my cardiac arrest I had an echo, the person who did it told me it was approx. 35%, I was devastated as I felt I was doing really well!
Managed to see my GP the same afternoon, he really reassured me and as he said the numbers are just that, numbers, how you are feeling is the most important thing.
At 10 weeks post surgery it sounds like you are doing really well, so don't let the 'numbers' hold you back.
The trauma of the events mentally can take longer to heal than our wounds, hopefully the help you get will speed that recovery up, good luck on your journey.
An EF of 45% is not too bad. I was told mine was 20% - nobody pointed out that this was down from around 55% rather than 100%, so I panicked a bit. I was not really aware anything was wrong though. With exercise, meds and a pacemaker, it is now in the normal range, so improvement is possible, how much depends on your condition. You can certainly live and function well, just forget Olympic golds in the more extreme sports.
Hi. Thanks for your reply. Pleased that you are doing well. I think the nurse really scared me because she didn’t explain anything. She just said that she would speak to the cardiologist to see what he thought about it being as “low” as the echo report suggested. No idea when I’ll hear back. I’ve got no clue what my ef was previously as I didn’t even know what it was. It’s so reassuring to hear that it can improve. Thank you again for your reply 😊
The nurse probably did not feel qualified to comment in case she did something wrong. I would make a list of things you want to ask when you next speak to your cardiologist. I am still dependent on gadgetry and meds, but I am grateful for what they have done. I hope a similar outcome is possible for you.
Hi. Thank you. I won’t get to see the cardiologist apparently as it’s nurse practitioner led where I am. Unfortunately the nurse prac, while being a very nice person, tends not to be particularly reassuring. I think aftercare is a bit of a lottery 😟
I think the one I have contact with is just not very reassuring. I’m sure she’s very capable otherwise. I’ve met plenty doctors with rubbish bed side manners too. Maybe because I feel so vulnerable at the moment Im struggling to cope with it and being over sensitive.
I feel really lucky because I think in my region there has been a huge drive on how to deal with patients. It can be almost overwhelming. Not what I have experienced in other regions when accompanying relatives!
Doctors tend to throw statistics around without considering the effect on patients.I had a similar thing with my kidneys where the doctor said their percentage function was a really scary amount and sent me to a consultant who said that was based on a young, fit, person. It was down a much smaller amount from the normal for someone of my age.
I think the lack of info that I’ve been provided with by the cardiac team just adds to my anxiety. Thanks for your reply and I hope that you are doing well.
Hi - after my 2nd HA last March I had an EF of 30-35 and it was same last Sept. As others have said figures of 50-70 are kind of normal ones as lower ones don’t pump as much blood around your body. But, it’s only a figure and I still go walking, biking and a bit of jogging etc without any issues. Drugs like Entresto & Dapagliflozin (which I’m now on) might help get your EF higher as might exercise - or at least hopefully stop it getting worse! I’d discuss your concern with your GP but personally wouldn’t worry unless I was getting out of breath a lot or my ankles were swelling etc. Good luck👍
I had my mitral valve repaired (not replaced) in 2018 and at that time my EF was 62% both before and after the surgery (I never had any symptoms despite the regurgitation having become severe). Had regular check-ups thereafter and all was fine until November 2020 when I was told my heart function had diminished and my EF was 41%. I was prescribed medication but queried why this should be when all reports said my surgery had been very successful. Subsequent MRI and nuclear medicine scans revealed that I had had a "silent" heart attack at some time between my surgery and the latest check-up - I honestly did not notice any symptoms at all and still had no breathlessness or fatigue - which had caused some damage and necrosis which would be permanent. I have just had an angiogram which showed that there is still no problem with my coronary arteries and my EF on this occasion was 49%. I was told to just continue with the medication (ramipril 2.5mg) and this does seem to be helping. The cardiologist had told me to carry on exercising but to avoid very strenuous forms of exercise.
Hi. Thanks for replying. This forum has become a lifeline for me. People are so supportive and informative. I’m also on rampiril but only 1.25 as I’ve got really low blood pressure. I’ve read research somewhere that says that EF reduces after MV surgery which surprised me as I thought it would improve it. Who knows. Anyway I’m pleased you are getting better and thanks again for your reply.
As others have said, an Ejection Fraction of 45 is not too bad. Mine was less than 35 after my heart attack two years ago but is now 47-51.
I can certainly feel the difference as I don’t get nearly so breathless or exhausted. As from the meds, I think the key is continuing to take the right amount of exercise each day. This obviously depends on your age and fitness level. I aim to walk around 7-8k steps including 15 minutes brisk walking.
Hi thanks for replying. I appreciate it. I’m walking about 40 mins a day but need to improve on that. I’m waiting for cardiac rehab. I think that exercise and taking the right meds might make a difference but the aftercare here is a bit haphazard. 😦
I had a heart massive attack 8 months ago at 59yrs I was very fit and exercised before that. It left me with permanent muscle damage and at that point my EF was 40%. After medication and a gradual return to exercise ( still not at pre heart attack level) it’s 46%. The main symptoms I have are when I’m walking upstairs or hills, and getting fatigued. But I’m working on specific things to improve this. It’s a very gradual improvement which is frustrating but improvements are a good feeling. Don’t let words bring you down my GP has labelled me with left ventricular failure which sounds depressing but in reality my left ventricle is working better than it was, its not perfect- but who is. And it’s becoming more efficient. Keep doing what your doing. X
Hi. Thank you so much. You’ve had a hell of a time but it’s good to know that you are getting better. The heart attack must have been terrifying.
I think that medical folk forget the impact that their comments can have sometimes. The nurse scared the hell out of me and then, of course, I did the worst and googled it. I must stop doing that!! It’s been a huge relief to read the messages sent to me, I am so grateful that people take the time to reply.
NEVER google. If you must,then stick to sites like the BHF. The NHS website doesn't tell you much. Best bet is to phone t he BHF nurses.They now operate 9:00 - 5:00 M-F, and 10:00 - 4:00 weekends and bank holidays. Their number is 0300 330 3311.
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