hello, i had a cto mid lad that was stented july 2013 and an echo nov 2013 that was basically normal with ef of 55-60% and no other significant structural abnormalities. for last six months or so have been having increasing episodes, symptoms of weakness, fatigue, unusual tiredness, some shortness of breath and an overall feeling like my body is not getting enough oxygen. Had an echo done late march and saw dr. yesterday and he said it was normal w/ ef of 50-55% and even though I am having symptoms that describe heart failure that is not possible w/ that ef. I asked for a copy and looked at it at home and was disturbed to see that it says I have a moderately dilated left atrium w/ volume/bsa of 34 when just 4 months ago my LA was normal in size w/ a vol/bsa of 27. There is also mild mitral regurgitation where there was none before. suspiciously, there was no mention of left ventricular diastolic function and my dr. did not suggest any medication and has in the past said beta blockers were not indicated for me nor recommended ace inhibitor. I am very upset that things seem to be going in the wrong direction and am now sorry i had artery, which was well collateralized opened at all. plus I have lost trust in my dr which is very disheartening. plus I seem to have lost my appetite and am wondering if that is somehow connected to heart. can heart failure start episodic or is it a static condition that is always there? any insights would be appreciated.