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Echo and Muga
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Echo and Muga

I have had idiopathic dilated cardimyopathy for 5 years.  Through out that time my echos and mugas have showed the same EF within a few points.  Although the EF has gone up and down during that time period, the changes were consistent with each other. During the past year I have had two echos (completed at different locations), and two muga's (completed at the same location).  Six months ago my echo showed an EF of 40, a drop of 15 points.  Whereas, the muga showed an EF of 55.  Last week the echo showed an EF of 32 and the muga showed an EF of 61.  Can you explain why the testing results would now be showing such wide discrepencies?   The echo is showing a downward trend, while the muga is staying the same. Which would you say is showing the most accurate reading of what is going on with my heart?  My doctor does not know what is happening and says my EF is somewhere between 32 and 61.  How would you interpet these results?  Thank you, Jan
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Dear Jan,
A echocardiogram (echo) uses ultrasound waves to image the contractions of the wall of the heart.  It is a 2 dimensional image of a 3 dimensional object.  A multigated analysis (MUGA) scan is a nuclear scan that measures the changes in nuclear counts in the heart over a period of time.  Normal ejection franction is between 50 and 75%.

Of the two tests echo is more subjective and is more dependent upon the skill of the individual doing the study and the experience of the reader.  A MUGA scan is less open to error although they can still occur.  

I don't think that your EF is between the two but is rather on one side or the other.  As to which one is accurate?  I would have to look at both tests as well as you and then make an assessment as to which one to believe.  If I had to do it without that information I would probably believe the MUGA.
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