Sudden drop in EF

[irishwife93]

Hello everyone,

I recently posted about my husbands severe anaemia and had some really helpful feedback on what to do about it. Shortly after that post I noticed crackling in my husbands lungs and convinced him to get to A&E as he was breathless at rest. They’ve done an ultrasound on his heart and his EF has reduced from 45% to 20% in a very short space of time - he has been seeing a heart failure nurse every two weeks and on the 7th of July his EJ was in the mid 40s. The consultants have said his heart seems to have overworked itself and is a bit exhausted. I’m not sure whether the hot weather has had something to do with it, he has had no cardiac rehab since having his HA 10 weeks ago but has been building up his fitness by walking on the advice of the cardiologist. Now I’m worried he’s potentially been over doing the exercise, we were given a booklet from the hospital which we followed to a T for the first 8 weeks but since then he’s been exercising a bit more, walking for 5km + and the hot weather can’t have helped. I’m worried he’s worn his poor heart out and I hope it will recover again. Has anyone else had this experience where they’ve gone one step forwards and two steps back in their recovery? My husband is only turning 40 today and we only recently got married, he was perfectly healthy up until this heart attack and I’m so scared of loosing him. If anyone has any positive advice I’d really appreciate it. Im trying my best to stay away from google at the moment as I don’t want to worry myself until we get answers from the consultant.

Incase it’s of use my husband takes aspirin, lanzaprazole, dapaglioflozin, arvostatin calcium, Bisoprolol, Ramipril 1.25mg twice a day and Eleperenone. They’re hoping to switch him to Entresto to reduce some of the pressure on his heart, he has very low blood pressure so not sure how soon they’ll be able to do this.

[Hidden]

Its unfortunate to say the least that your husband has been struck down by heart disease given his age. On that you both have my sympathy. However I can't give you specific advice about your husbands situation since I don't know his detailed medical circumstances, nor am qualified to comment, but all I can say is to follow the directions and treatments given by your health professionals which are based on best practice, and take the medication prescribed. If medication side effects are apparent discuss them with your GP at least. I imagine a good healthy diet will also give him the best chance of recovery. But for exercise you have to follow what the medics tell you and also listen to your body when it comes to recovery. As for cardio rehab unfortunately that seems to be a postcode thing made worse by catchup from the effects of the pandemic, but the BHF have an online rehab course available which might be worth looking up. Otherwise talk to your cardio team and find out where he is in any queue for rehab at your local health trust. Finally the BHF have a Helpline with a nurse available, so if you feel you need to get an alternative take from a health professional it might be worth talking things through with her. Otherwise I wish you both well.

[irishwife93 in reply to Hidden]

Thank you for the advice Hidden ! Since my husbands discharge after his HA, he hasn’t been placed under a proper cardio team. He was treated at a different hospital to our local hospital and I think he’s fallen through the net. The long waiting lists haven’t helped and whenever I ring through to the department I’m just told he’s on the waitlist and to wait for our letter. Now he’s been admitted the cardiologists here have him on their radar. We’ve spoken to a lovely cardiologist today who believes exercising wouldn’t have caused the dramatic drop in EF and it’s more likely his medication isn’t quite cutting it at the moment. Switching to Entresto should help so fingers crossed we see an improvement once that happens!

[Dessert]

I’m so sorry about your husband . I know it’s hard at a young age . I had two heart attacks at a young age too . I had to fight to get on to Cardio rehab . They have two levels - 1) for the more fit - 2) for the less fit .

I eventually got on to number 2! The group I was put in was all women except for one man . And it was rubbish .and lasted 30-4 0 mins . Most women left after 2 weeks! . I missed it one morning and went to another group, It was ALL MEN ! And it was fantastic! It lasted 3 hours!

They had 1 hour Q&A , 1 hour exercise , 1 hour relaxation .

So I would suggest that you and your husband be persistent about getting cardio rehab.

I listen to the professionals but I listen to my own body to and try to get them to do the same . They don’t know my body like I do!

On this site there was information that hot weather affects the heart which I wasn’t aware of . You and your husband can read it as he goes for walks in hot weather

Also people have written that Cardio nurses on this site help. There’s a phone number . Maybe you could call them?

Good luck ! Xx I’m sorry I couldn’t help you further . I’m not a medic . I can only refer to my own experience xx

[irishwife93 in reply to Dessert]

Hearing your own experience is very helpful, I would never have known about the two levels of rehab if you hadn’t shared what happened to you so thank you for sharing and signposting me to the other info on this website 😊 thank you for sharing!

[Dessert in reply to irishwife93]

My absolute pleasure ! Xx. I’m so glad that I could help ! Just be persistent with Cardio Rehab and with your GP . And get your GP to contact your Cardiologist. And be persistent about that too, I was ! Your husband deserves a good and long life. Others get medical help and so should he ,

[RufusScamp]

My problems started with crackling in the lungs. It was dealt with with antibiotics and a diuretic. Since then, my EF has improved from 20% to 60% on Entresto and with an ICD. Improvement is possible. Obviously it depends on the original cause of the problem, but if your husband follows the advice for his particular case that will give him the best outcome.

[irishwife93 in reply to RufusScamp]

Thank you Rufus, it’s great to hear such positive things about Entresto. The doctors are now looking into whether my husband needs an ICD too, so it’s good to know we are not out of options.

[ph5019]

Hi,My HA was over 2 years ago, ended up with severe HF.

I was fairly fit prior to my HA and started my exercise ( walking) after about 2 weeks after.

There was no rehab at that time, I now realise that I pushed myself to hard to quickly and ended up back In A @ E with my heartbeat stuck on 148 bpm and fluid on my lungs. This was resolved and an ICD was subsequently fitted.

2 years later I can now walk several miles and do most things I want to.

I an much older than your husband and all recovery times are personal to each of us.

But my point is you can overdo things, but you can slowly improve.

Paul.

[irishwife93 in reply to ph5019]

Thank you Paul, it’s very reassuring to hear stories like this. I suppose it takes a while to get everything right after a heart attack - we are only 12 weeks in! Glad to hear you’ve made a great recovery though and I hope the same happens with my husband 🤞

[ph5019 in reply to irishwife93]

You are doing a great job for your husband, good luck for the future - Paul

[Hollyxyz13]

Hello.just wanted to offer my support.

my husband also had cracking in his lungs which was helped with diuretics and antibiotics.the fluid retention was a side effect of steroids.but then he got gout type symptoms from the steroids reacting with the frusemide.

I think I just wanted to say that the meds are a nightmare but there are always lots of options and other meds and treatments.

It often seems like two steps forward one step back.

You are a strong caring person and we are all here for you.xx

[irishwife93 in reply to Hollyxyz13]

Thank you for your kind words of support Hollyxyz13 , the meds are definitely not as straight forward as I thought they’d be but we will get there! I hope your husbands meds got sorted in the end, it’s difficult to predict how they’ll all interact with each other! It’s such a relief to have a forum like this, without it I would feel completely alone x