Three years ago i use to run for 10 minutes, today i am out of breath after 3 minutes. my ejection fraction was 49, is it possible it got worse? i am not obese anymore. 190 pounds?

The symptom could be due to deconditioning. Have you regularly exercised in the last three years? If not, deconditioning is likely the culprit. EF of 49% is borderline, not optimal. Do you know your EF in the previous 3 years and do you have any underlying medical problem? For an accurate assessment, medical history is very important.

This rather impressive exercise intolerance is concerning. You've already had an echocardiogram but has a cardiologist thoroughly quizzed & examined you & looked at an EKG & chest x-ray? Your ejection fraction is borderline low. You may be scheduled for a medicine stress test because of limited exercise ability. If no cardiac cause, consult a pulmonologist for evaluation & testing.