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

### input:
Dr. Rynne My husband who is currently at the age of 61, underwent a triple bypass heart surgery back in 2011 due to CHF. Post surgery he had a ejection fraction of 25%. Since his surgery he has stopped smoking and reduced his weight by 40lbs. He currenty weighs in at 170lbs., with a height of 5 11. He has been on the medications of carvediol, simavastin and a cholesterol med since the surgery taking 2 doses a day, yet with his weight loss and reduction in blood pressure, his meds have been reduced to 1x p/day for the past six months. His recent labs revealed low cholesterol and normal range for all other areas. His recent echocardiogram within the last 10 days revealed an ejection fraction of 35%. Can we expect this ejection fraction to improve even further over time, or is my husband still at risk for CHF? I appreciate and thank you in advance for your opinion. Thank you Lizette

### output:

Hello, I have gone through your question. Your husband underwent bypass surgery, and it is indeed good that his EF improved to 35% from 25%. Actually such improvement depends on pre bypass state of muscle of heart. If bypass it was irreversibly damaged due to heart attack, then there would be no scope of improvement. In case of your husband 10 % improvement is significant.however 35% is moderate dysfunction .so he must continue medicines regularly with regular check up. Ramipril in permissible dose as per blood pressure will help him. He has very less chance of going into Frank heart failure. My best wishes Chat Doctor. 