ejection fraction from 44% to 28% Help Please

[aldousmh]

hi all

i have do two hart valve replacement when i was 18 , i was fine now and now i am 35 , in 2013 i checked my EF it  was 44% so it still ok for someone with my condition  in 2015 i check it agin and it is now 28% , my doctor give my Co-Diovan half pill every day , and ask to check after 6 month but he didn't look good when talking to me.

now i am very stressed , i have 3 kids and i want to improve my EF can any one let me know what i can do ?

appreciate  anyone input.

Regards  

[aldousmh]

The notes are

prosthetic aortic and mitral valve with normal excursion , prosthetic aortic valve mismatch.
severe left ventricular systolic dysunction , worsen from previous study from 44% to 28% .
elevated left ventricular filling pressure .

thank you very much , do i need to change the valve ? or what i can do ?

[ed34]

I'm not an expert with replacement valves, but I know in normal valves 7.4mmHg is pretty poor, indicating MODERATE stenosis. If the mitral valve is insufficient, it can cause enlargement of the left ventricle and left atria as you have. Have they not indicated concern over your mitral valve?

[aldousmh]

17 years ago i change them to titanium today there is no leak below are the notes

please help

1-marketed left ventricular enlargement , global hypokinesia , LEVF 28%
2-market left atrial enlargement  , other chamber are unmarketable .
3-Bileaflet prosthetic aortic valve , normal excursion , mean pressure gradient 26 mmHg.
prosthetic mitral valve , normal  excursion , mean pressure gradient 7.4 mmHg.
4-no pricardial effusion.
5-no intracardiac thrombus , mass , or vegetation .
6- normal great arteries .
7-Doppler echocardiography did not show paravalvular leak. E/E=25.
8-Bigemini PVCs observed .

[ed34]

So 17 years ago did you have mechanical or tissue valves put in? What does the echo show for your valves today? any leaks?