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What Does Ejection Fraction Of 65% Indicate?
Question: I am a diabetic since last 15 years , initially doctors advised Nebivolol 5mg and Aspirin 75 mg along with insulin human mixtard 30/70, Telmisartan 80 mg and Glycomet GP2 Forte. Later I had developed some breathing trouble and doctor prescribed for asthakind for 10 days followed by advice of Echocardiogram.
Echocardiogram showed LV ejection fraction 65%. then doctor stopped nebivolol and aspirin. I developed palpitation and very fast heart rate around 108 . again doctor started nebivolol 5 mg and aspirin 75 mg along with insulin 30/70 (20+20 units), teslmisartan 80 mg, glizid M, Lipaglyn 4mg .
But I started developed breathing problem and gets relieved by taking Asthakind syrup twice a day.
should I need to take asthakind for longer period for this breathing problems?
Echocardiogram showed LV ejection fraction 65%. then doctor stopped nebivolol and aspirin. I developed palpitation and very fast heart rate around 108 . again doctor started nebivolol 5 mg and aspirin 75 mg along with insulin 30/70 (20+20 units), teslmisartan 80 mg, glizid M, Lipaglyn 4mg .
But I started developed breathing problem and gets relieved by taking Asthakind syrup twice a day.
should I need to take asthakind for longer period for this breathing problems?
Brief Answer:
Switch to Ivabradine from Nebivolol.Continue the rest.
Detailed Answer:
Hi dear.Thanks for your query on HCM.
I really appreciate your interest in sharing the detailed clinical history.
Ejection fraction of 65% indicates a healthy pumping function of the heart.I hope that your blood pressures, cholesterol and sugars are well within the normal limits.
Nebivolol is given by your doctor for controlling fast heart rate.But nebivolol also has a tendency(side effect) to cause breathing difficulty in few individuals as in your case.
Terbutaline(in Asthakind syrup) is a bronchodilator and expands your lung and relieves breathing difficulty.
Hence, I would switch from Nebivolol to Ivabradine(which is equally effective in controlling your heart rate).Ivabradine does not cause breathing difficulty since it doesnot act on lungs/bronchus and is a safe alternative.Thus there is no need for asthakind syrup.
Ivabradine should be started and monitored as per your physician's advice.Continue the rest as per his advice.
Hope this answers your query.Get well soon.
Switch to Ivabradine from Nebivolol.Continue the rest.
Detailed Answer:
Hi dear.Thanks for your query on HCM.
I really appreciate your interest in sharing the detailed clinical history.
Ejection fraction of 65% indicates a healthy pumping function of the heart.I hope that your blood pressures, cholesterol and sugars are well within the normal limits.
Nebivolol is given by your doctor for controlling fast heart rate.But nebivolol also has a tendency(side effect) to cause breathing difficulty in few individuals as in your case.
Terbutaline(in Asthakind syrup) is a bronchodilator and expands your lung and relieves breathing difficulty.
Hence, I would switch from Nebivolol to Ivabradine(which is equally effective in controlling your heart rate).Ivabradine does not cause breathing difficulty since it doesnot act on lungs/bronchus and is a safe alternative.Thus there is no need for asthakind syrup.
Ivabradine should be started and monitored as per your physician's advice.Continue the rest as per his advice.
Hope this answers your query.Get well soon.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks Dr. normally I maintain 150/90 however in the evenings it rises to 167/107 . what should be the mg of the Ivabradine and what should be the doses? should I abruptly stop nebivolol and start Ivabradine?
Brief Answer:
I would prefer stopping Metoprolol and when introducing Ivabradine
Detailed Answer:
Hi dear.Thanks for writing me back.
Starting dose of Ivabradine is 5mg and it has to be uptitrated(to 7.5mg) depending on the symptoms.I prefer stopping Metoprolol and introducing Ivabradine at the same time since both act on heart muscle.Caution not to use Ivabradine without your doctors supervision.
Your blood pressure is on a little higher side(Normal <140/90).I would prefer to add a calcium channel blocker (eg. amlodipine) in addition to telmisartan 80mg to control your blood pressure.
Recommend 30-40 minutes of walking.Practise yoga, meditation and reduce the intake of salt(not more than 2g/day) in your diet.Hope this answers your query.
Feel free to post further queries.
I would prefer stopping Metoprolol and when introducing Ivabradine
Detailed Answer:
Hi dear.Thanks for writing me back.
Starting dose of Ivabradine is 5mg and it has to be uptitrated(to 7.5mg) depending on the symptoms.I prefer stopping Metoprolol and introducing Ivabradine at the same time since both act on heart muscle.Caution not to use Ivabradine without your doctors supervision.
Your blood pressure is on a little higher side(Normal <140/90).I would prefer to add a calcium channel blocker (eg. amlodipine) in addition to telmisartan 80mg to control your blood pressure.
Recommend 30-40 minutes of walking.Practise yoga, meditation and reduce the intake of salt(not more than 2g/day) in your diet.Hope this answers your query.
Feel free to post further queries.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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