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  

[ed34]

unfortunately not yet

[aldousmh]

thank you , have you heard about stem cell  can they be cure .

[ed34]

They could give you a beta blocker to help with the speed of your heart. The leg swelling and pain is due to the limitations of your heart, especially in cold air.

[aldousmh]

Yes co-diovan is blood pressure med , i have done full check up my all my health is good  , the only problem i feel i pain sometimes , this occur every week once mostly because  cold air or when i drink  cold .

i feel ok but my legs swelling sometimes , i didn't notice that until the doctor told it sign .  

now i am freaking out and very stressed even i am feeling my hart more than before which making it bets more .

[ed34]

I would ask your cardiologist (either visit or phone or write to him) and ask about the aortic and mitral valves. If it isn't the valves, then that leaves just a few other things which don't fit in my opinion. The first would be coronary artery disease, but the arteries would need to be in a shocking condition. The second is a viral infection that's attacked your heart muscle but I don't see it being that. The third would be very high blood pressure, but again, I don't think your blood pressure would be that high. Fourth is a genetic issue with the heart muscle, but again I can't see it being that. If it's your aortic or mitral valve or both then yes, they will need replacing. What is co-diovan? a blood pressure med?

[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 ?

[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?