Enlarged Heart / is that OK?

My nephew is 20 and he is very active in sports and in great shape. But, he has been very short of breath recently though to the point he almost turned blue and they had to take him to the ER. He went to a cardiologist who did an echo and the Dr. said he had a 35% ejection fraction and that he had dilated cardiomyopothy. Then on a phone call to my nephew's Father the Dr. said that he did not have an enlarged heart but just that it was sluggish (Whatever that means). He wanted to order a MUDA scan to confirm the findings but that it might not be anything to worry about.

He had the MUDA scan last week and at the Dr. today the Dr. said that my nephew does NOT have cardiomyopathy but that he has an enlarged heart. He said this is probably nothing to worry about but wants him to take a stress test because of the shortness of breath.

This all sounds liked mixed signals to me. First he has cardiomyopathy, then he doesn't, he didn't have an enlarged heart but now he does. I asked my wife what the MUDA scan showed for an ejection fraction but she didn't know. So unfortunately I don't what the results were.

So, If this is finally the correct diagnosis is an enlarged heart anything to worry about? I googled it and every single article said it was bad. I think they are going to get a 2nd opinion but any help meanwhile would be great !!
Thx !

[Cleveland Clinic]

A MUGA scan is a nuclear scan designed to characterize the heart's ability to pump blood, or ejection fraction. It is a quantitative assessor of this number, which is usually more accurate than an echocardiogram. He probably has what is known as an athlete's heart, which is characterized by a dilated heart with normal systolic and diastolic function, and without severe hypertrophy. This is in contrast with HOCM ( hypertrophic cardiomyopathy) which has sever ventricular enlargement, normal or small sized chambers and usually diastolic dysfunction.
This does not seem that the physician is really comfortable with the diagnosis, so I suggest you seek a second opinion, preferably at a tertiary care center such as ours.

[sb023]

Thx for the reply,
I have some more info now.

The Dr. never said he had dilated cardiomyopathy but that he wrote that on the prescription for the MUDA scan to "look for" that.

The results of the MUDA scan was a 46 % ejection fraction.
The Dr. also said he had a slightly enlarged heart.
All in all the Dr. said he was fine and just wanted to monitor him and do the MUDA again in another 6 months.

I am still concerned because 99% of all the internet sites say that anything below 50% on a MUDA scan is not good because even 50% is on the low end.

What is your opinion of a 46% MUDA, is that OK or does that warrant concern?

Thanks again !!