### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi, I am a man 45yo, had hart infarct last year + angioplasty (3 stents), left ventricol got some damage as I arrived very late to the hospital.After one year the echo shows a FE of 47%, they say  won`t get far than that probably, due to the delay of the surgery, got no symptoms, sporting aerobics 40min. a day ,feeling good, only during the sleep I wake up sometime feeling high heartrate, say round 80<>100, during daytime is always 70/75, my drug therapy is: cardioaspirin 100mg, metropol 50mg, perindopril 8mg, crestor 20mg.Do I have to expect bad arrhythmias and could my FE increase furhter? also I would like to ask if supplements such as coenzyme q10 and L carnitine are of help in such cases.Many thanks in advance.

### output:

Hellothanks for posting here. I have gone through your history. The medications you are taking are proper and in accordance with the latest guidance. Metoprolol also helps to control the heart rate. So i don't think there is any need of worrying about the increased heart rate in the night. Next, since you have mentioned that you presented late at the hospital some amount of heart muscle seems to have been lost. that's why the EF of 47%. Since that muscle is dead, the chances of further increase in EF is not expected. However an EF of 47% is a satisfactory to good EF. You. Can lead a normal day-to-day life without any significant symptoms even on exertion. But you need to continue these medications as they prevent remodeling of the heart. Please continue with your aerobics, diet restrictions and medications, and regular check-ups. And you will have a normal symptom free life. CoQ and carnitine decrease the metabolic requirement. Of the heart and can be taken. But more important are diet modifications, exercise, cardiosprin, metoprolol perindopril and creator thank you