How risky is LVEF of 32% after heart attack?

My dad suffered a major heart attack in the last week of Aug 2008. He underwent angioplasty and was in hospital for almost 12 days. As per the doctor, it was a massive heart attack and there were two blockages of 99% and 95% respectively in LAD.[ It was silent heart attack and the procedure was done after 8 hours the attack started. Unfortunately, we had no clue that dad was suffering a heart attack 🙁 ]During angioplasty, which lasted for almost 2 hrs and 30 min there was a dissection, as there were two bends in the artery and i believe calcification because of the delay in procedure, which seems to have healed by now (as per a CT scan done one month after heart attack). My dad seems to be perfectly healthy with no symptoms whatsoever. However, we got an ECHO done 10 days ago and it showed an LVEF of 32% and EFof 35%. I am worried. Is this serious? My dad looks perfectly fit, walks for 2 hours everyday and has no chest pain, breathlessness etc.

3 Responses to “How risky is LVEF of 32% after heart attack?”

  1. c_schumacker Says:

    It sounds as though your Dad has been through a lot.

    An ejection fraction 32% is not ideal but is adequate to get around in world perfectly well. It is important that his blood pressure is extremely well controlled (never over 125, sys). Other risk factors of cholesterol, smoking, and diabetes also need to be very well controlled. If your father is an otherwise healthy person, I would imagine he can live a nearly unimpeded life, even if his heart function never improves from where it is.

    At this late stage I have seen heart function continue to improve to the point where it is eventually in a near normal range. I am sure his cardiologist has him on a regimen of medications, which should help. Persistent activity is important to promote this, also. (Vigorous walking >3mph, 30 minutes several times a week).

    Lastly patients who have an EF of less than 35% qualify for a implantable defibrillator. It is not a light decision and your Dad is close to the cut off number. It is probably at least worth a conversation with his cardiologist on his next visit, if it hasn’t already been discussed.

    I hope this helps. Good luck.

    P.S. You now have a major risk factor for cardiac disease. Talk with your doctor about being screened for other risk factors and aggressively treating them now if present.

  2. jack Says:

    After a massive heart attack he is expected to have a low EF. I am sure your father got excellent care as per the report you have given.
    He must be on good treatment according to your cardiologists advise.
    An EF of 35 % after 4 months of heart attack without any symptoms even on walking is excellent prognosis.
    I am sure he is as good as he can be at present. Just follow your doctors treatment, diet and exercise programme. Keep in follow up with your cardiologist regularly.
    Give him good rest and relaxed atmosphere at home.

  3. Mark M Says:

    I don’t personally like the idea of blindly trusting one’s cardiologist. I think it is great that you are trying to learn more and help your father, and yours is a very good question.

    Many doctors do not want to mention the dreaded words “cardiomyopathy” or “heart failure”. It is a serious condition and should be taken quite seriously. Your father deserves to know his prognosis better than, “follow doctors orders and you will be fine.” If his doctor can’t do any better than that, I suggest getting a second opinion from a heart failure specialist, particularly one at a cardiomyopathy clinic.

    Here’s a medical paper I found on the subject. I found it very enlightening:

    http://www.chestjournal.org/cgi/reprint/128/4/2626

    I would recommend finding out what medications your father’s doctor has prescribed, and reading up on what they do. It is also a great idea to get a second opinion. Cardiomyopathy is not all that common, so you may find that you need to take him to a big city to find an appropriate doctor.

    One other thing: EF stands for “Ejection Fraction”. LV stands for Left Ventricle. Usually, the terms EF and LVEF refer to the same thing, but perhaps his RVEF is down, as well? Typically, a diagnsosis of cardiomyopathy is made when LVEF or RVEF falls below 50%.

    For further reading, I recommend starting at wikipedia: http://en.wikipedia.org/wiki/Cardiomyopathy

    Feel free to contact me for further research, if you would like.