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EF of 46%

EF of 46%

I had a stress test last year with a ef of 53 On cotober this Year a EF of 46% last year the doctor let me go to 108% of my target HR not to mention they had much better equipment. The equipment in this last study was kind of old. States that my left ventricle does not dilate during exercise. I ride bicycle aproximately 180 Miles at a very decent speed and I do race from time to time. Last year on the interpretation it reads rest and stress images show mildly decreased uptake in the inferior wall, but is actually worst at rest than is at stress. Therefore representing a diaphragmatic atenuation. EF of 53% is the exercise killing me?>
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967168_tn?1320843760
I'm not exactly sure, but I don't think so - I've read others on my icd forum living full lives with ef of 20-40% but have pacemaker/icd's so I'm not sure what the difference is.

In July 2009, my EF was 55-60% [echo]; at the end of August 2009 it was 45% [PM/ICD surgery] a 10 -15% drop in 5-6 weeks, they were concerned and told me we were going to watch it closely and said I have non ischemic cardiomyopathy [I think Hypertrophic since I have LVH]
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367994_tn?1304957193
An EF is the amount of blood pumped into circulation with each heartbeat.  The measurement is not static and the left ventricle dilates (non-pathologically) to increase contractions according to the Frank/Sterling law of physics (as an anology a hand spring when stretched will recoil more forcefully...over stretch it will be become flaccid, as does hypercardiomyopathy).  This compensation is required to maintan a balance between left and right side of the heart.  It seems the left ventricle of the heart would dilate and the heart rate would increase as well with exertion.

Sometimes your diaphram (breathing muscle) can cause what appears to be an area of ischemia (low-blood flow) in your heart. This is a "diaphragmatic attenuation artifact." It may be a true "fixed defect" or it may not be anything at all.

Because your doctor indicated some significance to the uptake flow to the heart, it would not be unreasonable to conclude there is a "fixed defect" and means that you have a complete blockage, or an almost complete blockage to a terminal segment of the artery going to your heart. Exercise is supposed to dilate your arteries. So a fixed defect means that there was no ability to dilate that segment and to deliver further blood to that area. It can mean you had a previous infarction (heart attack). However, the condition is mild and if it were serious your EF would be much lower probably in the below 29% range....  Are you stating blood flow to the inferior portion of the heart is worst at rest?

I had a reduced uptake to a portion of my heart, and an EF 13 to 29% range.  Medication and a stent to the RCA has effectively treated the condition and currently my EF is in the normal range (50-70%).

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