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What can cause Low LVEF if there is no obstruction & heart dimensions are normal?

A few months ago an ECG was performed on my wife. The report suggested LBBB. Subsequently an Echo-cardiogram was performed. LV wall wall thickness and cavity size was found to be normal. The Echo relieved regional wall motion abnormality. CAG was also done. The CAG report was also found normal (the doctor said that there may have been a block which has been canalized). Is the low LVEF due to LBBB?

She also experience chest pain (pressure in the chest, especially during breathing in) and shortness of breath (at the time of/after climbing stairs, walking very quickly or walking with heavy object). What could be the cause of these symptoms?

Her doctor has prescribed her Aspirin, Atorvastatin Calcium, Frusemide, Spironolactone, Carvedilol, Sacubitril 24 mg + Valsartan 26 mg. Is there any chance that her LVEF would increase?

Her NT-proBNP was found to be 390 pg/ml is that something to be worried about?
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Avatar universal
I think based on the findings and her symptoms being pretty severe, I would seek other  ( multiple opinions).

If it is a lbbb than it can be paced.

If it is cad, than she need cabg.

You have options.

I would get her on with at least 2 other specialists in 2 different cities asap!
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5 Comments
But her CAG revieled no blockage. So can CAD be ruled out?
Is there a way I can send you a message with my number so its not public.  This is compmicated to explain via text.

But there is what is pressumed to be cannulization of a previous thrombus.  Which means the vessel ( not sure which one) can still be acting abnormally.  Not to mention radiology is super subjective.  Dr. X sees no blockage, while Dr. Y. Sees clear blockage.  There is a lot of grey area.
You can email me. mcash.***@****. I can email you the images of the CAG.
Oop mcash(dot)pd(at)Gmail(dot)com
I have also sent my email address via private message of this website.
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