Cardiomyopathy update

Greetings!

After my successful Natale ablation three years ago and ticking along in sinus rhythm, I experienced chest pain and stress induced cardiomyopathy from reeling in a King Salmon on an Alaskan fishing adventure June 19, 2016. My ejection fraction dropped to 35% but my coronary arteries were clear. Another name for it is Takotsubo cardiomyopathy and it happens to otherwise healthy people. After the ablation three years ago, the six month TEE showed the LAA emptying velocity was 40cm/sec and I was able to discontinue blood thinners.

Dr. Natale put me on Eliquis after the heart attack until he saw me last week. The Echo and TEE in Austin showed my ejection fraction has improved to 55% but my LAA emptying velocity has slowed to 35cm/sec. The A waves peak at 35cm/sec (whatever that means). Dr. Natale wants me to stay on the Eliquis for another six months and then repeat the Echo and TEE. I might be able to get off the Eliquis and beta blocker but that is to be determined.

Dr. Natale was pleased with the way my heart is recovering from the stress induced cardiomyopathy and thinks it is unrelated to the afib or ablation of three years ago.

Betty

Interesting, you learn something new every day

Thanks
Mark

Hi Betty - I'm so glad you are doing well and that the cardiomyopathy isn't permanent.
Not that I'll be doing something similar to reeling in a salmon, but it's a good warning about stress-induced CM!

Please take care and continue with good progress.

Kind regards,
Jackie

Hi Betty,

Is cardiomyopathy considered a heart attack? Did Dr Natale call it that? I too recently had cardiomyopathy on 8/13/2016 after the sudden death of my son. They called it broken heart syndrome. I had two ablations with Natale. Last one was a LAA isolation on 9/18/2015.
I still have chest discomfort & pain. Are you experiencing anything like that?

Best wishes,

Jake



Edited 1 time(s). Last edit at 09/17/2016 10:20PM by Jake.

Jake,

I'm sorry to hear of the death of your son followed by your heart attack. Broken heart syndrome is also known as stress induced cardiomyopathy or Takotsubo cardiomyopathy. It was first described about 1991 by a Japanese physician who said the hearts of these patients looked like a Takotsubo octopus trap in Japan. It happens to people with normal coronary arteries.

The pain and clinical presentation of this kind of heart attack is like that of any heart attack. Cardiomyopathy is what follows as the heart changes shape and the muscle walls don't contract well. If one survives the initial insult of the heart attack (and some don't), there is an excellent chance of recovery. Some recover quickly in a few days and some take months. Much is unknown.

Dr. Natale told me I have Takotsubo Cardiomyopathy. The first month I had chest pain and discomfort just from being alive. The second month the chest discomfort was more with exertion. Now I get chest discomfort when stressed or I overdo it. So that part is getting better. I have nitroglycerin to take for the chest pain but have found that if I stop what I'm doing and rest a few minutes the chest pain goes away. I take a beta blocker to make the rate slower and stronger, and Eliquis because of a slower emptying of the LAA. Dr. Natale thinks I might be able to get off these drugs in the future as this improves.

Have you let Dr. Natale's office know about your situation in case he has something to add to your treatment plan?

Take it easy and rest your heart.

Betty

Thank you Betty,

Yes I am working with Dr Natales office. They have agreed on what my local cardiologist is doing. I was in the hospital for three days. My fraction rate was 33%. I was in a mental brain fog & it was over a weekend. They did a cardio cauterization because one cardiologist thought for sure I had a blockage. I did not, had clear arteries. No heart damage. Went home with a life vest so I could bury my son. Two weeks later the vest was gone & my echo showed FR of 53%. However the pain is still very persistent. I will call Dr Natales office tomorrow for their input. My local cardiologist put me on Ramipril 5mg a day & said the pain is just probably my heart mending. Its been 5 weeks. I have had this tightness after each ablation & thought it was the healing process from that? Nitroglycerin does nothing for me but to give me a headache.

Im wondering how common cardiomyopathy is with Afib & ablated hearts?

Did you have your LAA ablated Betty?

Thank you for your kind words.

Jake

Hi Jake,

I have not had my LAA ablated. So far I've had one ablation three years ago and have had normal sinus rhythm since. Six months after the ablation I was able to discontinue the warfarin due to acceptable LAA function. However with the cardiomyopathy, Dr. Natale put me on Eliquis and I've got to stay on it for now.

The local cardiologist gave me Nitro for chest pain but I've not tried it since the chest pain goes away in a few minutes if I stop and sit down. They thought it might help if the pain was caused by spasms of the coronary arteries instead of stress.

I've never heard of chest pain being caused by the heart mending. Surely there is a reason which makes more sense. Since your ablation was a couple months ago, your EP could help you sort this out.

You wonder how common cardiomyopathy is with afib and ablated hearts? It is a great question. I don't know. Maybe somebody else knows.

Best wishes for your ongoing recovery.

Betty