Brief Answer:
I would recommend as follows:

Detailed Answer:



Hello XXXX!

Thank you for asking on HCM!

First of all I would like to congratulate you, for overcoming such a dangerous and life-threatening heart attack (as a "widomaker" MI seems to be). Many people fail to survive such a harmful cardiac condition, or remain with important underlying injuries that limit their daily activity and predict a poor long term prognosis.

You are a lucky man! You have undergone an important heart attack with only a mild left ventricular systolic dysfunction.

This is a relatively good outcome for an individual suffering an important acute MI outside the hospital (considering that a good valuable time is spent for reaching the XXXXXXX lab in a hospital center and performing primary angioplasty, which may stop the damage progression).

So, an important time for saving jeopardized ischemic myocardial mass, is usually spent to contact with a coronary XXXXXXX lab available center. This has direct implications on prolonging door-to-balloon period, at the expense of what is called window period of reversible myocardial damage.

Nevertheless, I would say that yours is one of the preferably possible alternative consequent clinical scenario after "widowmaker" MI.

A LV ejection fraction of 45-50% signifies only a mild LV systolic dysfunction without any obvious implications of what is called heart failure. So, you will not have daily activities limitations or clinical signs and symptoms of overt heart failure (dyspnea, edema, etc). So, just relax for the moment and don't be so concerned!

My advice for the moment goes on what is involved in an optimal medical therapy, life-style (enough physical activity) and diet modifications (Mediterranean diet is strongly recommended), to achieve as much as possible the prevention of adverse myocardial remodeling progress (which commonly happens after an important MI and leads to significant LV dysfunction), as well as avoiding possible coronary risk factors in the future (close smoking contacts, control BP, high blood cholesterol levels, glucose intolerance, etc.).

Your actual therapy seems perfect in view of the above purposes. I would just suggest the addition of a statin (such as atorvastatin, rosuvastatin, simvastatin, etc), if no contraindications exist.

You have to talk with your attending doctor about that.

Regarding possible overall and cardiac performance improvements, I would recommend any available cardiac rehabilitation programs in your medical center of attendance.

You need to ask your cardiologist about the above mentioned issues.

Hope to have been helpful to you!

Feel free to ask me whenever you need! Greetings! Dr. Iliri

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Brief Answer:
A statin may help to stop the plaque progression.

Detailed Answer:

Hi again XXXX!

A satin will help in stopping the further plaque progression to a more severe vessel narrowing, and to the best possible scenario, it may even decrease plaque volume (this may be true if optimal doses of the statin are used in conjunction with other beneficial measurements i mentioned you above).

Wishing you good health!

Best regards,

Dr. Iliri

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