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Treated for spot on rib back. Having cough and feeling weak. How to increase ejection fraction?

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Cardiologist, Interventional
Practicing since : 1998
Answered : 410 Questions
I am 71 and was in relatively good shape until last july .At that time I did have some radiation treatment for a suspected spot on my # 6 rib on my left back. I have had two stents in my heart, one 14 years ago and one four years ago. I now have no energy and chest discomfort at the least effort and also have a cough that every two or three days will produce a small amount of yellowish flem, and then things quiet down again for a couple of days. Things have gotten significantly worse the past couple of weeks and I do have a doctors appointment scheduled for tomorrow. I had my nuclear stress test six weeks ago and had an ejection fraction of 26, down from 42 last July. My feeling is the low ejection fraction is causing my symptoms, is there any way to increase my ejection fraction with drugs, diet, exercise or therapy of some kind. I would like to know some possible options and courses to pursue before I XXXXXXX with the Doctor so as to intelligently discuss my options.
Posted Mon, 18 Mar 2013 in Hypertension and Heart Disease
Answered by Dr. Prabhakar C Koregol 48 minutes later

Thanks for the detailed query.

You must be having heart weakness due to coronary artery disease or could be due to radiation you were exposed to. But with EF (Ejection Fraction) 20% and symptoms, treatments options become mostly independent of cause.

Yes you will be benefited by medicines such ACEi(Angiotenesin Concerting enzyme inhibitors), Betblockers, Digoxin and Diuretics. Diet and exercise in rehabilitation manner would also be useful in guided and graded course. In case it is appropriate, you may also be considered for CRT (Cardiac Resynchronisation Therapy).

Of course if doctor suspects new blocks as cause for recent worsening, there is always a role for coronary angiogram and revascularisation especially surgical.

Hope I answered your query.

Please do let me know if there are any other concerns.

Above answer was peer-reviewed by
Follow-up: Treated for spot on rib back. Having cough and feeling weak. How to increase ejection fraction? 44 minutes later
Since the nuclear test showed no blockages six weeks ago what other non-invasive methods are there to determine blockage other than catherization and how accurate is the nuclear test for finding them?
Answered by Dr. Prabhakar C Koregol 12 hours later
Thanks for writing back.
Here, two issue becomes very important : What was level of exercise attained? Also how was it done pharmacological vs exercise. If an adequate level of exercise is attained , then it would be enough else a CT Coronary angiogram can be considered. Even the accuracy depends on heart rate, level of exercise and many such factors.
Let me know these details and we can discuss further
Above answer was peer-reviewed by
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