37 yrs old, ef 45-50% past 1.5 years, halter normal, stress test lbbb w/ normal sinus rhythm, echo shows lbbb, constant fatigue & dyspnea symptoms? y

Cardiomyopathy: You have a cardiomyopathy. This causes fatigue and dyspnea. Assuming your echo and stress test are normal (other than lbbb, which is due to cardiomyopathy), you should be treated with a betablocker like Carvedilol and an ace inhibitor like lisinopril. These may improve your ef and symptoms over time. Sometimes a diuretic and aldosterone antagonist and digoxin are used as well.