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Is There A Genetic Component To Lower Ejection Fraction?

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Posted on Wed, 2 Sep 2015
Question: I have an ejection fraction of 30% but no history of heart issues. I had a XXXXXXX stent put in 6 months ago and my EF hasn't improved more than within the rate of error even though I've also been taking standard medication, quit smoking and improved my diet. My questions are: Is there a genetic component to this to where a low EF occurs throughout a lifetime without the accompanying CGH indicators? Also, are there issues with individuals where an echocardiogram or MRI would give misleading results? As I look back on my life it appears that my EF has always been low. Background: I've exercised aerobically pretty intensely for over 20 years (while continuing to smoke and having a fairly poor diet) 2-4 times a week. Prior to that I was a typical idle XXXXXXX and I have always been overweight to some degree regardless. However, I don't feel that sluggish most of the time though I do tend to nap, and have for as long as I can remember.
doctor
Answered by Dr. Lilit Baghdasaryan (2 hours later)
Brief Answer:
Need more information

Detailed Answer:
Dear Sir,

I have some additional questions
1. If I understood correctly XXXXXXX stent is LAD stent, how much was the blockage, was there any other blockage?
2. How did they found that you have low ejection fraction, did you have any complaints or it was just regular check up?
3. Have you had any symptoms ever, such as chest pain or dyspnoea on physical exertion?
4. Is there anyone from your family members or close relatives with heart issues?

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Lilit Baghdasaryan (6 hours later)
LAD is correct, my mistake. My blockage was complete, the assumption was that it was gradual over the years. Everything else was alright except for high blood pressure (130/90) and heart was larger than normal from retaining blood.

The EF was found during an exam to obtain drugs to quit smoking. I had a EKG in the doctor's office which led to a Catscan, echocardiogram and MRI. The echocardiogram was the baseline for measuring my EF.

I had recent chest heaviness before seeing the doctor but previously had no symptoms, no dyspnea. However, my legs did 'fall asleep' easily which I learned indicated poor circulation.

My biological father has a defibrillator since his 50's, but he is also a lifetime serious drinker/alcoholic with no exercise and bad diet. He is still alive and 78.

A follow up question would be: What can I expect for the future with proper diet and exercise, especially if I don't have a defibrillator installed?

Thanks.
doctor
Answered by Dr. Lilit Baghdasaryan (7 hours later)
Brief Answer:
Good contractile reserve, favorable prognosis

Detailed Answer:
Dear Sir,

In your case there are many predisposing factors, which could lead to cardiovascular problems, but not a single cause.
In case there was no blockage we could think idiopathic dilated cardiomyopathy , which could develop slowly and didn't cause any symptoms, but here we have ischemic heart disease as well. Anyway, it developed slowly during years, so you didn't have any complaints.
But there are good news as well. If you exercised intensively during years and there was no symptoms, it means that your heart has good contractile reserve, which is despite low ejection fraction at rest it can work quite hard during physical activity. It is one of the major good prognostic signs.
I think you have really good chances in term of prognosis if you continue to follow healthy lifestyle, exercise and follow your doctor's instructions.

Wishing you good health

In case of further questions don't hesitate to ask

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Lilit Baghdasaryan (5 hours later)
Thank you so much Dr. Lilit, I appreciate the information. None of the doctors I spoke with over time would give my years of exercise any consideration, nor did anyone mention contractile reserve (I looked it up, makes a lot of sense given my history and current state of health). They are pushing me now to have a defibrillator but I'm going to wait for at least 6 months and get another echo first, see if I can't get my EF higher.

If you don't mind, if I have more questions in he future I'll look you up.

Thanks again, take care.
XXXXXXX

P.S. This is the only connection I could think of with your country. If you want to hear one of our Minnesota locals who has become famous over the years Google 'Bob Mould Armenia City in the Sky.' Its a Who tune redone by XXXXXXX in the 90's.



doctor
Answered by Dr. Lilit Baghdasaryan (5 hours later)
Brief Answer:
Welcome back

Detailed Answer:
Dear XXXXXXX

If there will be no improvement of EF in 6 months I would advise you to undergo stress echocardiography, which is more reliable examination to reveal contractile reserve.

You are welcome with further questions

Take care,
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Lilit Baghdasaryan

Cardiologist

Practicing since :2007

Answered : 1536 Questions

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Is There A Genetic Component To Lower Ejection Fraction?

Brief Answer: Need more information Detailed Answer: Dear Sir, I have some additional questions 1. If I understood correctly XXXXXXX stent is LAD stent, how much was the blockage, was there any other blockage? 2. How did they found that you have low ejection fraction, did you have any complaints or it was just regular check up? 3. Have you had any symptoms ever, such as chest pain or dyspnoea on physical exertion? 4. Is there anyone from your family members or close relatives with heart issues? Regards,