Non-viable segments of left ventricle

[EU95PTM]

I had a stemi heart attack last year, which resulted in a LV thrombus and heart failure. I had an MRI recently that showed that my EF has increased from 39% to 56% which I’m really pleased about as the medications are clearly doing their job. Also that the thrombus has resolved so I can stop warfarin.

The report also detailed the tissue damage caused by the heart attack. This was the bit I was particularly interested to see as I was told on discharge that damage was “severe”. (Troponin levels were in excess of 25,000) but couldn’t really visualise what this would look like. The MRI has reported that 5 out of 17 segments of my left ventricle are non-viable. This is an alarming figure to me. Is anyone else living with similar amounts of damage? I will be discussing with my GP this week but just curious to see if anyone else living with the same?

[Hidden]

Hi there - congratulations on a great improvement in your EF! I hope this is also reflected in a lack of symptoms?

I had a STEMI in March 2019 at the age of 46 and have the same degree of damage. I am fortunate to remain largely asymptomatic, able to maintain a busy full-time job and exercise regularly. However, on repeat annual echocardiograms my EF has stubbornly remained in the 35-40% range. I am on Entresto, Eplerenone, Carvedilol, Rosuvastatin and Aspirin, and this cocktail seems to be keeping things ticking over 4 years on. I also elected to have an ICD implant despite a ‘borderline’ recommendation, which provides an added level of reassurance.

[EU95PTM in reply to Hidden]

Thank you. I’m pleased to hear you are living well. I’m mainly asymptomatic, just if I overdo it I can feel overwhelming fatigue. I’m walking briskly at least 5 times a week and trying to keep stress to a minimum. The meds are really working wonders and I feel much better than in the early days of recovery.

[EU95PTM]

Thank you for your comments, that’s a great way to look at it!

[jrcsheffield]

EU95PTM - hello - I was 63 when........

March 2021..After a 40 mile bike ride suddenly without any previous symptoms had a Stemi heart attack.

Advised by Cardio Professor this was caused by a thrombus or clot forming in heart. Had angiogram and three stents fitted. During this time also had three strokes, two of which affected occipital lobes and caused loss of peripheral vision for a week.I also still have slight balance,swallowing and other minor problems thought to be the result of the strokes.

Was told that 66% of heart muscle had now formed as scar tissue.

Ejection Fraction stayed constant after HA at 35%.

Volunteered for double blind drugs trial (Dapagliflozin) from day 7 after HA..with hope to see improvement of EF over time.

September 2021...Still no change in EF after 6 months but can now manage up to 20 miles on electric bike.

November 2021... was deciding whether to take offer of SICD/ICD from NHS, as a number of previous echo scans still showed 35% agreed with Professor to have a cardiac MRI scan.

June 2022 ...finally, requested Cardiac MRI scan showed my EF had improved from 35% to 48%, the decision to have an SICD/ICD fitted was therefore decided by NICE guidelines..NHS didn't usually fit at SICD/ICD above 40% EF. No wires or holes in my chest! Great news.

So getting on with my life, cycling up to 100 miles each week on Ebike gradually reducing power setting.

July 2022... Heart Failure clinic advise severe heart failure down graded to mild to moderate and I was discharged. (New York rating is now class 1).

I too am mainly asymptomatic, like you if I overdo it I can feel overwhelming fatigue.

I sleep 9pm - 7am and an hour in the daytime everyday.

All the best to you. I hope things improve further for you.

John.

[EU95PTM in reply to jrcsheffield]

Wow! John, you have been through a lot and I’m glad you are living a good life. Thank you for sharing your story. They started me on Dapagliflozin just 10 days after my stemi when it was clear from an echo that I had developed heart failure and it really has been a game changer for me.