Heart problems....but how serious?

[frankster]

I am a 31 year old male. I'm 6'1, 245. I am, from all outward appearances a very healthy, athletic looking guy. Despite weighing in the  245-250lbs range, I wear a 34-36 pants. I used to workout moderately with weights, but havent in 9 months due to a torn labrum in my shoulder.
Recently, I went to the E.R. for SEVERE heart palpitations. 4 hours later, I was given xanax and told, "You are having panic attacks. Please calm down." Three days later I went to my family doctor and he ordered an echocardiogram, which was then forwarded to a Cardiologist. The most significant aspects of the results were an ejection fraction of 30%, dialated/enlarged left ventricle, and endocarditis. He then scheduled a follow up with a Cardiologist, who suspected the echo was a mistake and he had me do a nuclear stress test. The nuclear showed an EF of "30-35%"..and basically confirmed everything in the echo.
The Cardiologist wrote in his notes, "Patient likely suffered a light heart attack. Cause unknown." I do not have an arterial damage or blockage. My BP is high. Even on meds, it was 150/100. The day I went to the ER is was 170/150.
I have been a police officer for 8 years. I obviously not a drug user, nor was i a user before my career. My medicinal history consisted of two months of Adipex and probably 10 years on and off of OTC "diet pills." I can only suspect what was in most of those otc pills, but the Dr. doubts anything otc could have produced the damage I now have.
I am now on coreg and Ramipril. I see him again in 3 months and we are going to retest the echo and stress test.
From what I have written, is my longterm prognosis/outlook look ok? How long can I live with an EF of 30% ? I do not need anything sugar coated. Blunt, truthful answers. I keep reading conflicting ideas and opinions. I even asked a nurse and never told it her it was me, and she said that she doubts anyone with that history will see old age.
I greatly appreciate any feedback you all may provide. Take care and have a blessed day.

[kenkeith]

Thanks for your response, and I can identify with what you say.

[frankster]

Thank you for the reply, kenkeith. I appreciate your time. I should have asked many of these questions to my Dr., but honestly, I was in a daze and couldnt believe what was going on. Now that reality has set in, my curiousity and just plain problem solving attitude took over. I have gotten so much different feedback from nurses i know who all but told me i was in grave anger, to nurses/doctors who have said my case is minor and not to worry. It seems my cardiologist falls a little in between. He is surprised at the damage of my heart, mostly because my age and athletic appearance.
I do not have my echo report, but i can easily attain it. when I do, ill post more.
Thank you again. and congrats on what appears to be a nice recovery for you too!

[kenkeith]

Quote: "The most significant aspects of the results were an ejection fraction of 30%, dialated/enlarged left ventricle, and endocarditis. He then scheduled a follow up with a Cardiologist, who suspected the echo was a mistake and he had me do a nuclear stress test. The nuclear showed an EF of "30-35%"..and basically confirmed everything in the echo..
The Cardiologist wrote in his notes, "Patient likely suffered a light heart attack. Cause unknown." I do not have an arterial damage or blockage....From what I have written, is my longterm prognosis/outlook look ok? How long can I live with an EF of 30% ?"
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>>>>>Your posted information is interesting, and raises some questions.
The ejection fraction may decrease if your heart has been damaged by a heart attack or problems with the heart valves or muscle. If you had a heart attack, your echo should show some hypokinesis (heart wall movement impairment), and if so where?  If there is hypokinesis, that can explain a lower than normal EF...normal EF is 55-70%

Endocarditis is an inflammation or infection of the endocardium, which is the inner lining of the heart muscle and, most commonly, the heart valves. It is usually caused by bacterial infection, but can be caused by fungus.  Did your echo show any damage to the mitral valve or aortic valve?  Was a blood test postive for an infection? An echo can be helpful in indentifying a valve disease. A valve insufficiency usually doesn't cause a low EF, but it does relate to a lower than normal cardiac output that can damage heart cells and eventually cause a lower than normal EF..

You ask if the EF can be raised to normal and that would depend on the underlying cause. Another calculation for left ventricle's viability to pump is the fraction shortening.  Rather than using volume of blood before and after cardiac cycle, it uses chamber dimensions.  Do you have the echo report?

Six years ago, I had an EF 13 to 29% (heart failure range) and was in ICU for several days with congested heart failure, and enlraged LV, mitral valve regurg, etc.  Currently, my LV is normal size and EF is 59%.  Medication, proper diet, exercise, etc. helped me.
Hope this gives you some insight; thanks for sharing.  If you have more information from your echo report, you can follow up with another post.  Take care.

[frankster]

I greatly appreciate the reply. Very detailed and explains alot. I think the cardiologist is hoping the  medicine will reverse the EF and bring it back up. Despite all of this, I know I am very lucky regardless. There are so many people who have worse problems than this.
Thank you again for taking the time to reply.

[is_something_wrong]

I'm not a medical professional, and I usually don't answer questions as complicated as this.

Dilated cardiomyopathy is a serious disease, but possible reversable, all depending on the cause. Endocarditis is a serious disease too, but as far as I know, usually treated with antibiotics?

What is really important, is that factors causing the dilation and reduced EF are corrected ASAP. An EF of 30% is not necessarily life threatening, and someone can live long with this condition, but it shouldn't get any lower. I suspect your diastolic blood pressure can possible have something to do with it, and it should be further reduced, probably to 120/70.

Lowered EF can cause arrhythmias, so you should visit the ER if you feel serious palpitations. Keep in close contact with your doctor / cardiologist.

If your condition get seriously worse, there are LVAD's (left ventricular assistant devices) that can help you, and heart transplants are also indicated in worst case.

You and your doctor need a plan for correct exercise, reducing blood pressure, get the endocarditis under control (if it's not, I would assume it was?), correct nutrition and if necessary, an ICD to prevent dangerous arrhythmias.

I hope you'll be OK, sorry this happened to you.

Best wishes!