How to increase my LVEF after angioplasty

[rpsangani]

I have gone through angioplasty [ 1 stent ] on October 25, 2013. Before angioplasty, my LVEF was 45-50%.  After angioplasty, my LVEF reduced to 30%. Should i be concerned?? How to get my LVEF back to atleast 45-50%..

[vedadhar]

Drop of EF after Angioplasty may depend on factors like sex,age,infarct location,previous infarction,single vessel disease,TIMI flow grade,Enzymatic infarct size,ACE inhibitors.

Considering each and every factor,associating it with present situation gives the possible explanation.Recovery time of LVEF to expected levels of 45-50% may take time depending on medications prescribed and associated complications.

I agree with explanation for fall in systolic/diastolic BP (expected physiological response),but it may not be associated with failure of primary angioplasty which was done recently.Angioplasty with stents is done to damaged vessels but what proves its efficacy in this situation if they are blocked with quick scarring?This may also prevent further heart failure.

Refer to case studies of eurheart oxford journals that talks about Long term recovery of LVEF after primary angioplasty for Acute MI.Search in google and download the pdf file.

[ed34]

Blood pressure is controlled by a few factors, not just the heart. Yes the heart has to work harder when blood pressure rises, and it can run faster to deliver blood to the muscles quicker. However, unless it is really weak, with EF lower than 30, then I can't see it affecting the pressure very much. Obviously with a low EF, it is better to keep a lower pressure to make life easier for the heart. I am assuming you are on medications to ensure this? such as beta blockers?
I would say your diastolic pressure looks pretty damn good, showing that the arteries are still very elastic. Your systolic looks low, but as I said this is great for letting a sick heart work easier. You would normally expect a pulse pressure of around 40, which is systolic-diastolic.
To control pressure, the smaller arteries in your body constrict and relax, making the pathway for blood narrower or wider. A bit like squeezing a hose pipe in the garden. Your body can also utilize fluid stored in the kidneys and put more water into your blood, to build up pressure.
What I am really curious about is why your EF dropped so much after Angioplasty? It should have remained the same for a few months, or increased quite quickly. There are only two possible conclusions for a Stent to cause such a dramatic EF drop that I can think of. First is that the Stent blocked quite quickly with scar tissue. Second is that even though a stent was inserted, heart muscle damage had already occurred. I personally think you require a nuclear scan to determine just how much muscle has been affected and if it's reversible. Would I be concerned with an EF of 30% ? yes. I say yes because 30% if the threshold for heart failure. I would be asking my Cardiologist a lot of questions to try and establish exactly what is going on and then decide on the best action to take from that data. Without knowing the exact reason for the drop in EF, it would be difficult to suggest anything really.

[rpsangani]

was monitoring my BP during exercise.

6 Mnt brisk walking [@ ~4.8 KM speed]

BP pre walk: 110/80
BP Post walk: 100/70
BP Recovery: 100/70

Ideally, BP should increase. But in my case, my BP got decrease by 10% after 6 mnts brisk walking..

can this because of low EF?? just curious...

[vedadhar]

Since you have undergone angioplasty in October 25,2013, with only 1 stent,LVEF-45-50% before surgery may indicate single vessel disease.

You were a elected candidate of surgery at that time because you fall under a category of Preserved Ejection Fraction (>40% but <60%),which indicates you had a previous heart attack and no heart failure, which is a good thing.In most of the patients undergoing Angioplasty,there is a significant and slow rise in EF from previous values.But in some patients, it may fall low 40% i.e.Preserved LVEF,diastolic heart failure may complicate condition.So talk to your Doctor and reassure yourself that there will be constant/slow rise in LVEF.Do not get too anxious or excited about your present situation,it does not help you but worsens your situation.Consider management in a hospital if odds seem to bother you.

Try to post the same question in expert forums of medhlep in Congestive heart Failure or Heart disease community to seek answers from professionals.All the Best,Stay calm,God Bless!