Dr. Fett med question

[Nails]

Dr. Fett I just had my one year echo and muga. My heart is back to it's 'normal' size and my ef is 61%. I did not get to talk to my cardio about these results because he was running late that day but his nurse called and told me the good news and said that I was to stay on all my meds and in 6 months we will run all the tests again.
I am extremely interested in discussing the possibility of living my life unmedicated with my doctor in 6 months but I know he is very, very attached to the idea of me remaining medicated. I was wondering if you can give me any information, statistics, websites, or anything like that I could use so that I have some logical, well educated argument for possibly backing of the medication. Thank you very, very much for this and all your help!
-Neely

[SusanD]

I hope Dr.Fett doesn't mind, but as of right now there are no studies specifically involving recovered PPCP patients and removal of beta blockers and ACE inhibitors. We *do* have studies involving DCM patients and their outcomes after coming off beta blockers were not so good.

While we are lacking good hard statitistics, we *do* have women here who have gone off AI and BB under the close and watchful eye of their cardio ( and with frequent echo's as well) and who have done just fine. Just as alarming, however, are the women who have seen a decrease in EF.

[JAMESFETT]

tHAT'S fine, Susan D, I don't mind at all. I think the best answer is that no one really knows when to stop treatment in PPCM. It is clear, however, that careful weaning of medications can be done, following left ventricular function, and that is a safe process. I believe treatment should continue at least for one year following diagnosis, because personal experience of instances of deterioration when some patients did not return for followup and continuation of Rx, this is in Haiti. I would retain a beta-blocker (carvedilol) for the longest time, and I would not be hasty in stopping it, although reducing dosage is very reasonable. The important thing is to keep in close touch with your cardiologist, who has all the essential information for making medication decisions. I do wish more USA cardiologists did office echocardiography, not insisting on a full (and expensive) exam. For followup purposes in PPCM, it is quite simple and rapid to do an assessment of left ventricular size and systolic function by echocardiography.

James

[Nails]

Thank you both very much!