Low EF and leakage in the valve

[Namita29]

My dad has been detected with low Ejection Fraction of 25% through an echo test, also doctors say theres a leakage in his left valve, though the doctor also mentioned that the leakage is not that much that he should go in for surgery immediately. Now, he is kept on beta blockers and diagoxin. I would like to understand the follwoing:

- How sever is the problem, can it lead to sudden cardiac arrest?
- Can his EF be improved through medicines or he needs a surgery?
- What precautions should we take to reduce the risk and the improve the EF?
- What dietery plan should we follow?
- Does low EF mean theres danger to his life?
- Can he work normally, if his EF is improved in future?
- What is more dangerous low EF or valve leakage?
- Any other recommendations you would suggest in general.

Kind Regards,
Namita Saxena

[Douglas Bogart, MD]

A low ejection fraction is one of the predictors for sudden cardiac death and potentially your father would be a candidate for an implantable defibrillator.  The  medical treatment should include digoxin, beta blockers (carvedilol) and  an ace inhibitor.  Whether your dad should have surgery depends on the severity of the mitral valve leakage and his overall general condition.  At times the heart function and mitral regurgitation can improve on a good medical program.  He should follow a low sodium diet of no more than 4 grams of sodium daily.  Talk to the cardiologists about these things.

[Namita29]

Thanks doctor. Yes, he is been put on the exactly same medicines that you have prescribing. Also, as per doctors his leakage in the valve does not require immediate surgery. They have asked him to take these medicines for a month then will follow the stress echo test to see if he is has a cardio pulmonary disease. Do you feel we should wait for a month's time? Also, he is lost 3 kgs weight in 4 dayz, doctor says its normal as he has been put on digoxin (that will take away excessive fluid from his body). would also like to understand:

- Does avoiding excessive fluid intake mean that he should drink less water too?
- Can he drive or travel (air/road)

Regards,
Namita Saxena