Echo versus Stress Test Ejection Fractions

Can anybody explain the differences between ejection fraction results form an echo and a stress tess?  I had an echo in October that was 35% and a nuclear stress test in November that was 16%?  I have a defib/pacer if that helps.  Thanks

[Dr J Singh]

Hi,
Normally, there shouldn’t be such a difference between the echo & nuclear imaging EF but such a difference is possible only for RV ejection fraction where the nuclear imaging is slightly more sensitive than the echocardiography. The sensitivity of the echo also decreases where the patient is suffering from a lung disease like COPD when the proper window is not available to visualise the heart with the help of an echocardiogram. I sincerely hope that helps. Take care.

[arch0401]

Thanks for the reply and information.  I just had a breathing test and the results were all close to normal for my age (49).  My doctor felt the stress test result could be off because of my pacemeaker and is going to repeat the echocardiogram next week and put me on a holter monitor for 24 hours.  Just before Thanksgiving I was cardioverted to shock me out of an a-fib eposide but I think I am back in it.  I am experiencing almost none stop fatigue and shortness of breath, and my heart and check fill like a pinball machine form back in the 80s, even when sitting around.  My question is what is the new echo test or holter readings going to do that the stress test or a download from my defib wouldn't tell.  I'm not complaining - he is beng proactive in trying to determine what is going on - I am just trying to understand his logic.  Thanks

[Dr J Singh]

Hi,
Thanks for the feedback. I do understand your concerns. He might have suggested the echo & holter to reassess the status of the functioning of the heart, mechanically (by echo) and electrically (by holter). I do understand that quite a bit of information can be picked up from the downloading of defib data and also from the stress test. However, your physician wants be doubly sure by doing these tests. I sincerely hope that helps. Take care.