Posted 7/17/2006 1:15 AM (GMT -7)
A successful CABG sure should increase your EF. It revitalizes the heart muscle by greatly increasing the blood supply to your heart muscle that formerly had myocardium (heart muscle) that was deprived of adequate blood flow. An EF of 23 is not good Dizzy. SSDI requires an EF of 30 or less to qualify for heart failure. If your EF is truly 23, you have some degree of heart failure. It can certainly improve dramatically after CABG, if your heart was not significantly damaged from lack of coronary blood flow to the heart (prior to the CABG). Your EF should be at least 45. Normal for my age is around 55. Mine is 45.
You should have been through rehab, and should now be exercising under the direction of your doc of course. This can help "rebuild" your heart. Sometimes damaged heart muscle can be hibernating due to CAD, but can be restored to normal after revascularization (CABG). It other words, the heart muscle never died but was damaged and goes into hibernation.
If you are experiencing arrhythmias that are dangerous, like V-tach, I would talk to the doc about a pacemaker or ICD.
You may have not been taking so many heart medications prior to your CABG. Beta blockers and other heart meds can cause fatigue. If your resting BP is good or low, and your heart rate is good or on the low side, you may talk to the doc about reducing some of your meds or try a different med(S). I take my beta blocker at night, and my cardio knows it. It helps with the associated fatigue. Talk to the doc about which one of your heart meds that could be causing your fatigue or weakness.
Do you retain fluids? DO you watch the salt in your diet? Most people with heart failure take the newest beta blocker called Coreg. It is supposed to be better than the other beta blockers. I still take Atenolol.
Normal Bundle Branch Function
The heart's electrical activity normally starts in the sinoatrial node of the upper right atrium (the heart's built-in "pacemaker"), and travels to the atrioventricular node. From the AV node the electrical impulse travels down the Bundle of His, and divides into two branch bundles, one for each ventricle.
The function of the bundles is to speed the electrical impulse and distribute it in a pattern which makes later heart muscle contraction forceful and coordinated. As electrical impulses travel down these bundles, they spread over the associated ventricle to the muscle fibers, stimulating the fibers to contract in a rhythmic manner, squeezing blood out of the ventricles and into the arterial circulation.
Because the left ventricle is larger, the left bundle divides into an anterior left bundle and a posterior left bundle, the former controlling the front wall of the left ventricle, and the latter controlling the back wall of the left ventricle.
Bundle Branch Blocks
When bundles are injured, as in a myocardial infarction, or because of underlying heart disease, a bundle or a branch of a bundle may cease normal function. The result is an altered pathway for electrical heart activity. Since an electrical impulse can no longer use the bundle to travel, it may move instead through muscle fibers in a way that both slows the electrical movement and changes the direction of the impulses. As a result, the ability of the ventricles to effectively pump blood is impaired, and cardiac output — the amount of blood the ventricles can pump into the arterial circulation — is reduced.
Many people with bundle branch blocks may still be quite active, and may have nothing more remarkable than an abnormal appearance to their EKG. However, when bundle blocks are complex and diffuse in the bundle systems, or associated with additional and significant ventricular muscle damage, they may be a sign of serious underlying heart disease. In more severe cases, a pacemaker may be required to re-establish better heart muscle function.
An echocardiagram calculates an EF, but... :
The advantages of the MUGA scan over other techniques (such as the echocardiogram) for measuring the LVEF are twofold. First, the MUGA ejection fraction is highly accurate, probably more accurate than that obtained by any other technique. Second, The MUGA ejection fraction is highly reproducible. That is, if the LVEF measurement is repeated several times, nearly the same answer is always obtained. (With other tests, variations in the measured LVEF are much greater.) These advantages - along with its noninvasive nature - make the MUGA scan ideal for detecting subtle changes in a patient's cardiac function over time.
Good luck at your appointment. Make notes and take them with you :)