Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Is Ejection Fraction Of 25% A Cause For Concern?
Question: Thank you very much for your valuable assistance. Seeking information after visit to my cardiologist yesterday to acquire clearance for a hernia repair as surgeon requires this approval. Heart is 25 percent due to one good blood vein and two clogged ones in my enlarged heart. (two heart attacks) Asking about the build up of water retention growing in my stomach. Doctor says I have liver disease but no advise or explanation. Taking a prescription for several months called FUROSEMIDE 40 MG (LASIX) Aware of limitations of giving medical advise but wish to discover any treatment to heal liver other than water pills? Hospital has twice removed fluids with tube inserted in side. XXXXXXX 2016 took almost gallon & July 2016 1 and 1/2 gallons. Status is similar today. Appreciate help to determine if this is indeed caused by liver and steps for cure or treatment. Told previously due to heart condition, weak heart not strong enough to move body fluids. Sharing your thoughts most appreciated. Best, XXXX
Brief Answer:
Right sided CHF secondary to Left sided CHF!
Detailed Answer:
Hi,
Thanks for choosing HCM for your query!
Your ejection fraction is 25%, your symptoms are most likely because of congestive cardiac failure.Congestive heart failure (CHF) is a chronic progressive condition that affects the pumping power of your heart muscles. CHF specifically refers to the stage in which fluid builds up around the heart and causes it to pump inefficiently.
CHF develops when your ventricles can’t pump blood in sufficient volume to the body. Eventually, blood and other fluids can back up inside your:
lungs
abdomen(In your case)
liver(Reccuent congestion causes liver damage)
lower body
Right-sided CHF occurs when the right ventricle has difficulty pumping blood to your lungs. Blood backs up in your blood vessels, which causes fluid retention in your lower extremities, abdomen, and other vital organs.
This is exactly whats happening to you.Due to critical blockages in your coronaries your heart functions have detoriated.CAD can cause left-sided heart failure leading to right-sided heart failure. Or it can directly cause right-sided heart failure by blocking blood supply to the right ventricle.
Tab lasix is given to increase the excretion of extra amount of retained water in the body,by increasing the amount of water excretion, it reduces the symptoms of CHF.
Though Ascitis(collection of fluid in abdomen) can be because of liver damage also,yet most likely in your case its the heart not the liver.Damage to liver is secondary to heart.
However as per your question about treatment for liver regeneration, i would advice you to take sylimarin capsules twice daily for 3 months,it is a potent antioxidant as well as it helps to rejenuvate the liver.
However again my advice is that in your case its not the liver its the heart ,you should be started on betablockers,ace inhibitors,trimetazidine ,a loop diuretic with spironolactone. They will overall improve your cardiac status and ejection fraction may improve.A proper treatment should be started under a cardiologist.
Test advice-
2d echo
Tread mill test
lipid profile
liver function tests(Damage to liver can be secondary to congestion of fluif due to CHF)
Ultra sound abdomen
However the gold standard test is coronary angiogram and depending on the reports ptca or bypass surgery should be done,followed by medications!
In case you have any other query feel free to answer!
Thanks!
Right sided CHF secondary to Left sided CHF!
Detailed Answer:
Hi,
Thanks for choosing HCM for your query!
Your ejection fraction is 25%, your symptoms are most likely because of congestive cardiac failure.Congestive heart failure (CHF) is a chronic progressive condition that affects the pumping power of your heart muscles. CHF specifically refers to the stage in which fluid builds up around the heart and causes it to pump inefficiently.
CHF develops when your ventricles can’t pump blood in sufficient volume to the body. Eventually, blood and other fluids can back up inside your:
lungs
abdomen(In your case)
liver(Reccuent congestion causes liver damage)
lower body
Right-sided CHF occurs when the right ventricle has difficulty pumping blood to your lungs. Blood backs up in your blood vessels, which causes fluid retention in your lower extremities, abdomen, and other vital organs.
This is exactly whats happening to you.Due to critical blockages in your coronaries your heart functions have detoriated.CAD can cause left-sided heart failure leading to right-sided heart failure. Or it can directly cause right-sided heart failure by blocking blood supply to the right ventricle.
Tab lasix is given to increase the excretion of extra amount of retained water in the body,by increasing the amount of water excretion, it reduces the symptoms of CHF.
Though Ascitis(collection of fluid in abdomen) can be because of liver damage also,yet most likely in your case its the heart not the liver.Damage to liver is secondary to heart.
However as per your question about treatment for liver regeneration, i would advice you to take sylimarin capsules twice daily for 3 months,it is a potent antioxidant as well as it helps to rejenuvate the liver.
However again my advice is that in your case its not the liver its the heart ,you should be started on betablockers,ace inhibitors,trimetazidine ,a loop diuretic with spironolactone. They will overall improve your cardiac status and ejection fraction may improve.A proper treatment should be started under a cardiologist.
Test advice-
2d echo
Tread mill test
lipid profile
liver function tests(Damage to liver can be secondary to congestion of fluif due to CHF)
Ultra sound abdomen
However the gold standard test is coronary angiogram and depending on the reports ptca or bypass surgery should be done,followed by medications!
In case you have any other query feel free to answer!
Thanks!
Above answer was peer-reviewed by :
Dr. Yogesh D
My inquiry Was pretty specific and explained I was seeking advice from a physician who had answers for my health issues regarding possible liver failure. The last thing in the world was another cardiologist repeating the same advice. Did I not make it clear I just came from a cardiologist who expressed no information on actions or preventive action on Ascitis?
Requested advice from Internal Medicine or liver doctor for deeper discussion on liver disease or steps to what treatment is available.
During my 4 prolonged stays in hospital during 2016, I was under the care of five (5) consulting cardiologists who had many blood and heart monitoring test performed on me. This continued repetition now explained once again does not answer a simple question I had reached out and asked. Every cardiologist has same outlook from their perspective without addressing my follow up concerns. Being subjected to many IV's and many drug prescriptions but keeping me in the dark on other health issues.
Very disappointing to have a track record of now six (6) cardiologists who refuse to offer any options but surgery or lifetime of drugs. I asked EBIX for medical opinion for liver disease treatment and receive point of view from my heart condition. I obviously am aware of my weak heart since experiencing it first hand and medical expenses of $300,000.00 and counting.
Thanks for your effort, but you are regurgitating same message as others and fail to answer my inquiry as you are not a liver specialist.
I will continue to explore and conduct medical research on my own. No need to follow up or reply to this message.
Requested advice from Internal Medicine or liver doctor for deeper discussion on liver disease or steps to what treatment is available.
During my 4 prolonged stays in hospital during 2016, I was under the care of five (5) consulting cardiologists who had many blood and heart monitoring test performed on me. This continued repetition now explained once again does not answer a simple question I had reached out and asked. Every cardiologist has same outlook from their perspective without addressing my follow up concerns. Being subjected to many IV's and many drug prescriptions but keeping me in the dark on other health issues.
Very disappointing to have a track record of now six (6) cardiologists who refuse to offer any options but surgery or lifetime of drugs. I asked EBIX for medical opinion for liver disease treatment and receive point of view from my heart condition. I obviously am aware of my weak heart since experiencing it first hand and medical expenses of $300,000.00 and counting.
Thanks for your effort, but you are regurgitating same message as others and fail to answer my inquiry as you are not a liver specialist.
I will continue to explore and conduct medical research on my own. No need to follow up or reply to this message.
Brief Answer:
.
Detailed Answer:
HI,
I am sorry for your disappointment,
For your liver problem ,some medicines are there ,but most of them are still under trial and a definite result on liver rejenuvation is yet not documented or proved in Trials.
1)Silibinin, also known as silybin , is the major active constituent of silymarin, it is used in the treatment of toxic liver damage.
Mechanism of action-Silymarin has metabolic and cell-regulating effects at concentrations found in clinical conditions, namely carrier-mediated regulation of cell membrane permeability, inhibition of the 5-lipoxygenase pathway, scavenging of reactive oxygen species (ROS) of the R-OH type and action on DNA-expression, for example, via suppression of nuclear factor (NF)-kappaB , in lay mans language its a potent anti inflammatory and antioxidant,and a liver tonic,
But according to NCBI trials- The potential benefit of silymarin (extracted from the seeds of Silybum marianum or milk thistle) in the treatment of liver diseases remains a controversial issue. Analysis was performed on five trials with a total of 602 patients with liver diseases,The evidence shows that, compared with placebo, silymarin produces a nonsignificant reduction of total mortality by -4.2%.
Antioxidants like vitamins A, C and E, and the minerals copper, zinc and selenium and may prevent some of the damage caused by free radicals by neutralising them. These include the nutrient antioxidants, vitamins A, C and E, and the minerals copper, zinc and selenium.Hence can be taken to provide protection for further liver damage.
Glutathione derivatives are beneicial-Glutathione is involved in many processes in liver, including tissue building and repair, making chemicals and proteins needed in the body, and for the immune system.
But the last resort treatment is surgery!
Thank you!
.
Detailed Answer:
HI,
I am sorry for your disappointment,
For your liver problem ,some medicines are there ,but most of them are still under trial and a definite result on liver rejenuvation is yet not documented or proved in Trials.
1)Silibinin, also known as silybin , is the major active constituent of silymarin, it is used in the treatment of toxic liver damage.
Mechanism of action-Silymarin has metabolic and cell-regulating effects at concentrations found in clinical conditions, namely carrier-mediated regulation of cell membrane permeability, inhibition of the 5-lipoxygenase pathway, scavenging of reactive oxygen species (ROS) of the R-OH type and action on DNA-expression, for example, via suppression of nuclear factor (NF)-kappaB , in lay mans language its a potent anti inflammatory and antioxidant,and a liver tonic,
But according to NCBI trials- The potential benefit of silymarin (extracted from the seeds of Silybum marianum or milk thistle) in the treatment of liver diseases remains a controversial issue. Analysis was performed on five trials with a total of 602 patients with liver diseases,The evidence shows that, compared with placebo, silymarin produces a nonsignificant reduction of total mortality by -4.2%.
Antioxidants like vitamins A, C and E, and the minerals copper, zinc and selenium and may prevent some of the damage caused by free radicals by neutralising them. These include the nutrient antioxidants, vitamins A, C and E, and the minerals copper, zinc and selenium.Hence can be taken to provide protection for further liver damage.
Glutathione derivatives are beneicial-Glutathione is involved in many processes in liver, including tissue building and repair, making chemicals and proteins needed in the body, and for the immune system.
But the last resort treatment is surgery!
Thank you!
Above answer was peer-reviewed by :
Dr. Remy Koshy
Well I spent two hours to respond to your comments and explain what steps I was taking to treat myself. Exercise program and 30 supplements as well as current prescriptions.
Keeping this short. The computer failed to send out the reply message and has lost it.
Wish to thank you for your insights and providing medical information I was seeking.
Appreciate sending advice to assist me in being better informed.
You have answered my questions and grateful to receive your answers.
Thanks very much.
Best, XXXX
Keeping this short. The computer failed to send out the reply message and has lost it.
Wish to thank you for your insights and providing medical information I was seeking.
Appreciate sending advice to assist me in being better informed.
You have answered my questions and grateful to receive your answers.
Thanks very much.
Best, XXXX
Brief Answer:
.
Detailed Answer:
Welcome.
Good luck and wish you a safe recovery!
Thanks.
.
Detailed Answer:
Welcome.
Good luck and wish you a safe recovery!
Thanks.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
