Does my echo report indicate any bigger issue?

Hello,

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These are changes due to AWMI (anterior wall myocardial infarction). You are having dysfunction of the heart, which is of moderate intensity. It is a significant dysfunction, but manageable. Normal functioning of the heart is more than 55 %, and yours is 40 %. Survival chances are very less with heart functioning less than 15 %, so you have sufficient reserve. Now, the priority is to prevent further damage to the heart, which can be by healthy lifestyle and medicine. You should visit a hospital if any recurrence of chest pain, chest heaviness, or sudden onset sweating, etc. You should have a healthy lifestyle as follows. Avoid fatty, oily, and high-calorie diet. Have low-salt diet and monitor blood pressure regularly. Blood pressure should not be persistently more than 140/90 mmHg. Do regular exercises like brisk walking or just walking according to your capacity for at least 30 minutes a day and five days a week. Consume a lot of green leafy vegetables, fruits, fish once or twice a week, and avoid meat. Avoid smoking and alcohol if any. Also, you need to be on medicines like Atorvastatin or Rosuvastatin, Aspirin, Clopidogrel, Ramipril, beta blockers like Metoprolol, Spironolactone, etc., which I guess you must be on. Also, your lungs need to be evaluated once, and you will need a chest x-ray and if necessary HRCT (high-resolution computed tomography), if not done earlier. Hope this helps you, and get back if you have any doubts.

Hello,

Welcome back to icliniq.com.

Firstly, there are two reasons for decreased ejection fraction. One is the presence of block, which is not complete but 95 %. Due to this, there is continuously decreased blood supply to the heart tissue and gradually heart tissue becomes less functioning but not dead. This non-functioning is called as hibernation of the heart. Due to this, both heart function goes down, and heart function may improve after opening the vessel, which was the basis for your angioplasty and improvement in function to some extent. Some tissue was already dead, and some part was hibernating, so angioplasty had probably lead to slight improvement in heart function. Another cause is once the heart is damaged, then vicious cycle begins, and some internal factors kept on damaging the heart, and to prevent this we keep the patients on beta blockers, ace inhibitors, and spironolactone, which slow down the damage process. The likely cause for dilated right heart is fistula only, so if there is no need, then it should be closed. It is possible that right side was dilated to a small extent at the time of angioplasty only, but it was overlooked since it was minimal and now it has progressed over a year to a noticeable extent. An echocardiogram is highly observer dependent investigation, so it depends on the observer as well and what he considers as abnormal. Hope this clears your doubts.