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What Does Left Ventricular Dysfunction Mean; My Heart Doctor Said

Posted on Wed, 10 Oct 2018

Question: What does left ventricular dysfunction mean; my Heart doctor said my heart is at 30 % efficiency and should be 55% ...he prescribed coureg, which I began last night....he was in a hurry and I want more input...he wants to insert a camera into my veins, take a picture of my heart and decide if I need a stint; I had an EKG 2 times and an echo cardiongram yesterday....so what does this 30 % business mean?

Answered by Dr. Ilir Sharka (35 minutes later)

Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome on - Ask a Doctor - sevice!

I understand your concern, and would like to explain that you are suffering from what is called heart failure.

That means your cardiac muscle (myocardium) is weakened to the point that its blood pumping function is almost halved (the ejection fraction, which is an index to measure the heart pumping function during systole (contraction) has decreased from >50 (normal value) to around 30 percent).

Therefore comes the definition left ventricular systolic dysfunction: the heart is unable to efficiently pump blood through the body as is required in certain stresful situations (during physical or psychological strain, etc.). That's why the heart to compensate for such an inability begins to enlarge in order to maintain the amount of blood being pumped during each contraction.

Coming to this point, I recommend following your doctor advice regarding a careful medical therapy and period followups.

Hope to have been helpful to you!

In case of any further questions, feel free to ask me again.

Kind regards,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Ilir Sharka (49 minutes later)

Thank you for some clarity...But what about this: one of my hobbies is running and exercise. I walk, jog or run about 20 to 25 miles per week; I compete in 5K races. Last year, my 5K times were about 32 minutes...now I am doing 38 to 45 despite continued training; I usually train one day hard or vigorously and the next day easier. I also go to the YMCA 2 times per week instead of training outside; at the Y or gym, I do elliptical cardio, recumbent bicycle and treadmill about 3 to 5 miles...occasionall, I do water aerobics a d I always lift weights while at the Y... used to do 100 repetitions on the machines. During the summer, I increased it to 150...+ I do stretching....I feel great...but one day per week I workout with a team and that is stressful...we do up to 3 miles of sprints...ex, warm up, 2 times 200 meters, 3, times 3oo meters, 1 or 2 600 meters...etc up and down till we hit about 2.5 to 3 miles....I have also done about six 5 K races during the past 3 months...HOW CAN THIS BE THAT IN HAVE HEART FAILURE OR PROBLEMS...? what are the possible causes of this condition? Can you amplify or offer any explanation based on the information... I have an appointment with my GP in a few hours....thank you very much for your help, Sir.

Follow up: Dr. Ilir Sharka (3 hours later)

Thank you for your answer. This is what I do not understand: I am quite active and run 5K races, exercise at the gym, stretch and even do water exercise occasionally. How can my artery be in trouble or "constricted" (if that is the correct term)...? I ran six 5 K races withing the last 90 days and do all of the above....I normally run one very difficult workout per week with a team, which leaves be in need of rest.....basically, guess I am asking in view of all of my exercise and I think I eat well, why is this happening...am 5 feet 11 inches and 183 pounds...

Thank you for your help.

Follow up: Dr. Ilir Sharka (1 hour later)

see up above

Answered by Dr. Ilir Sharka (2 hours later)

Brief Answer:
Opinion as follows:

Detailed Answer:
Hello again!

I carefully reviewed all your life-style description and I would say it's amazing to see such a physically active individual despite the age.

I would like to send my congratulations!

Let me explain that heart failure is a clinical syndrome, it may appear when when a decrease in the overall physical performance is explained by some degree of cardiac dysfunction.

Not rarely specific changes seen in very active individuals may be mistaken for certain cardiomyopathy. In fact we may have to do only with what is called athlete's heart.

Nevertheless, we see individuals who may resent with decreased cardiac performance (decreased ejection fraction) and have no or minimal symptoms while on exertion.

We have to do in such case with what is called muscle and physical conditioning.

Coming to your clinical situation, I would say that you don't have to worry too much as far as you are doing quite well, your physical performance is excellent and no signs of heart failure (such as lower limbs edema, pulmonary congestion on physical examination (medical auscultation) or chest X ray study), are present.

In order to exactly differentiate the potential causes of your cardiac changes, it is necessary to carefully review your cardiac ultrasound report, ECG and other available tests.

A a general rule, a newly appearing heart failure is characterized by an abnormal increase in natriuretic peptides levels.

So, you may discuss with your doctor on the possibility of performing a blood natriuretic peptide (NP or NT-proBNP) level test.

In addition, it is necessary to proceed with further clinical investigations to review all the possible causes (coronary artery disorders, myocardial, etc.)

You should discuss with your doctor on the above mentioned issues.

I remain at your disposal in case you will need further explanations.

Regards,

Dr. Iliri

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

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