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What Are The Complications Of Having A Low Ejection Fraction?
My mom had a heart-attack and is still in the hospital. The doctors say she is stable but her EF is only 15%. Since the heart-attack happened mid air and lot of time was lost, the heart muscles were significantly damaged it seems. There was a block, which they removed. Again, she is doing fine now; just resting and getting stronger. The doctors said ICD is an option; not now but once she is strong. Age: 56 Here are my questions: 1. I know the EF is very low, but is it dangerous? What can we do about it? Is there a way to improve that at all? 2. What complications will she have with EF of 15? I am sure her life-style needs to change but what does it really mean? 3. She is currently in a hospital in India and is planning to come back home to California. How long should she wait before she can travel safely? She had her heart-attack last week. Your response is greatly appreaciated.
Tue, 8 Sep 2015
Hello. Welcome to HCM and thank you for your question. I understand your concern and let us take everything step by step together.
A 15% of functioning heart, means that this heart is only pumping only 15% of its content in every cycle, and is keeping 85% of it. While a normal heart pumps 55-70% of its content during one cardiac cycle. This can produce problems, because this insufficient and "impotent" heart cannot fulfil the periphery's need for blood (oxygen and nutrients) and also does not create an environment for blood coming from the lungs to have enough space to empty in cardiac chambers. This raises pressures in the lungs, and the risk of them filling with fluid is always imminent after a load is posed to this insufficient heart, such as minimal physical activity or salt intake, or fluid retention. Now, is this EF very low? Yes, it is, for the above mentioned reasons. Only precautions can be taken, such as restricting the daily activity only to everyday daily duties and restricting salt from the diet, because 1 g of salt retains 10 g of water, in the human body. If the PTCA and stenting was carried out within 6 hours from the onset of pain, then there is expected benefit of this muscle to return some of its function, not entirely, because it takes 6 hours minimally for consolidation of this damage of heart muscle cells, going from transitory injury to a permanent damage with non-functional scar tissue placement instead of healthy, normally functioning cardiac muscle cells. Besides the standard medication, in her therapy should also be included two diuretics and a angiotensinogen converting enzyme inhibitor (ACE-I). I would not be a bold doctor and tell you that it is safe for air travel, at least until she is stabilized and seen if any benefit to the heart muscle has been brought on by revascularization. An enlarged heart, after an infarction, is a subject for ventricular, potentially life-threatening arrhythmias, because of the scar tissue formation. Implanting an implantable cardioverter-defibrillator (ICD) is a good choice in a second time, because it would substantially prevent death from at least these malignant arrhythmias. Should they happen, this device will convert them automatically, by delivering a programmed electric shock.
I hope I was thorough with my answer. Take care.
My regards,
Dr. Meriton
A 15% of functioning heart, means that this heart is only pumping only 15% of its content in every cycle, and is keeping 85% of it. While a normal heart pumps 55-70% of its content during one cardiac cycle. This can produce problems, because this insufficient and "impotent" heart cannot fulfil the periphery's need for blood (oxygen and nutrients) and also does not create an environment for blood coming from the lungs to have enough space to empty in cardiac chambers. This raises pressures in the lungs, and the risk of them filling with fluid is always imminent after a load is posed to this insufficient heart, such as minimal physical activity or salt intake, or fluid retention. Now, is this EF very low? Yes, it is, for the above mentioned reasons. Only precautions can be taken, such as restricting the daily activity only to everyday daily duties and restricting salt from the diet, because 1 g of salt retains 10 g of water, in the human body. If the PTCA and stenting was carried out within 6 hours from the onset of pain, then there is expected benefit of this muscle to return some of its function, not entirely, because it takes 6 hours minimally for consolidation of this damage of heart muscle cells, going from transitory injury to a permanent damage with non-functional scar tissue placement instead of healthy, normally functioning cardiac muscle cells. Besides the standard medication, in her therapy should also be included two diuretics and a angiotensinogen converting enzyme inhibitor (ACE-I). I would not be a bold doctor and tell you that it is safe for air travel, at least until she is stabilized and seen if any benefit to the heart muscle has been brought on by revascularization. An enlarged heart, after an infarction, is a subject for ventricular, potentially life-threatening arrhythmias, because of the scar tissue formation. Implanting an implantable cardioverter-defibrillator (ICD) is a good choice in a second time, because it would substantially prevent death from at least these malignant arrhythmias. Should they happen, this device will convert them automatically, by delivering a programmed electric shock.
I hope I was thorough with my answer. Take care.
My regards,
Dr. Meriton
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