Q: I had a mild myocardial infarction 30 years ago. I am 70 years old now and have a problem of arrhythmia. Lately, my echo showed decreasing ejection fraction - EF (37%). My medications are cardivas, cardace, sporomide, chlordrel plus and atocor. Will these medicines improve EF? Is difficulty in getting sleep related to low EF?

A:Those medicines will improve your EF. Inability to sleep is not due to low EF unless you are getting breathless in the nights. The best way to improve EF is by revascularisation (CABG or multi vessel angioplasty) if coronary angiogramme shows multiple blocks in the tubes supplying blood to the heart muscle. This improvement will occur only if the heart muscle is not thinned out or scarred; the amount of live muscle that is not working because of less blood supply can be ascertained by an MRI or Nuclear test.