Harvard Heart Letter

Ask the doctor: Does a low ejection fraction doom me to inactivity?

Ask the doctor

Does a low ejection fraction doom me to inactivity?

Q. Two years ago, at age 64, I had a severe heart attack in the left ventricle that left me with a 20% ejection fraction. A recent echocardiogram showed that my heart is getting larger. I have no shortness of breath or swelling, but wonder how long I have before these symptoms of heart failure appear, possibly confining me to a wheelchair. I feel great, can walk 2 miles or ride a bike, and go to work every day. I take my medications (20 mg of Zestril and 25 mg of Coreg) and do the other things my doctor asks me to do. What does the future hold for this heart of mine?

A. Although you and your doctors are wise to be concerned and vigilant, don't walk (or sit) around feeling that you are doomed to develop heart failure. No one can tell you when — or even if — your quality of life will decline with a damaged left ventricle. You are doing everything right, which counts for a lot. Be sure to keep taking the highest doses of the ACE inhibitor (Zestril) and beta blocker (Coreg) that you can tolerate, and keep active. This will give you the maximum protection against progression of your heart problems.

— Thomas Lee, M.D.Editor in Chief, Harvard Heart Letter

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