Saturday Evening Post - Advances in heart care
Q: I thoroughly enjoy your discussions on heart topics, and wondered if you could address one of sudden interest to me. It concerns ejection fraction. Echocardiograms indicate that mine has dropped from approximately 43 percent to an alarming 34 percent in just a short period of time. Is congestive heart failure inevitable? My 14 grandchildren and I would appreciate any ideas. I have the latest Medtronic Virtuoso defibrillator working in my favor, unless that new lead fails. The newest of my many medications is Coreg.
I am glad you read my column and enjoy it. You don’t indicate the nature of your heart failure, nor whether you are symptomatic from it. Both of those things are important.
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An echocardiogram can be inaccurate in estimating the ejection fraction, and the first thing I would suggest would be to have it repeated, especially if you have had no change in symptoms. Perhaps the decrease is really not so significant. There is a lot of research being done in the area of congestive heart failure, both with medications and implantable devices, and even stem cells. Many places like ours now have specialized clinics for heart failure patients, and doctors who specialize in caring for these patients. Coreg is an excellent drug for this problem, and often an angiotensin-converting enzyme inhibitor or receptor blocker is added. Other drugs may be helpful as well. The Virtuoso should protect you against important heart rhythm problems. Just have the lead (I assume you mean the Fidelis lead) evaluated by your doctor.
ABOUT THE EXPERT
Internationally acclaimed car dialogist, distinguished professor, author and inventor Dr. Douglas P. Zipes is an authority on what is called pacing and electrophysiology (rhythms of the heart).
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