Q: My husband has had three heart attacks in the past four months. He is 39 years old. He has had 5 angioplasties, four stents, triple bypass, and now has a defibrillator. His ejection fraction is under 30%. He is eating properly, goes for physical therapy three times a week, walks the dog every night, and takes his medication. My question is, can the ejection fraction be increased? Can he live a normal life with an ejection fraction that low?

A:Ejection fraction can be marginally improved with regular exercises and collateral recruitment which again occurs with regular exercises. Certain medicines also help offload the heart and therefore improve the ejection fraction, in the form of Ace-inhibitors, and I am sure your husband must be under proper cardiological follow up because he has already undergone defibrillator implantation, multiple bypasses and angioplasties. Regarding your second query, yes, most certainly he can lead a normal life with an ejection fraction of 30%, as long as he makes certain sensible modifications in life style. He wont be able to do aggressive physical work or indulge in aggressive hobbies but if he adjusts his life style to relatively more modest levels, he should be able to lead a near normal life.