Re: Ejection Fraction

Posted By CCF CARDIO MD - DLB on September 18, 1998 at 16:56:39:

In Reply to: Ejection Fraction posted by James on September 18, 1998 at 09:54:43:






: : : After a Myocardial Infraction on Nov. 20, 1997, I had a caherization on 11-27-97 that showed a 40% ejection fraction. On 12-4-97 I had a Stress Cardiolite test that showed
: : : I had a 29% ejection fraction. On 2-6-98 I had Angioplasty . On 8-18-98 I had an echogram that showed I had an ejection fraction of 40%. After the heart attack I
: : : was told 40% of my heart muscle was dead. I had 100% blockage of the LAD and
: : : 99% of the D1. The Angioplasty was done because they thought there was some
: : : hibernating tissue and they were succesful in the surgery. Now they want to do a muger scan to check my heart function again. MY QUESTION IS  what is my ejection fraction 40% or 29% ,do I need another heart function test, and how do they determine how much heart muscle is dead. Thank You, James
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: : Dear James
It sounds like your doctors are planning to do a MUGA scan, which will provide a number for your ejection fraction (EF). Normal is around 65% (not 100%). Echo, cath and nuclear stress tests (cardiolite, MUGA) all give an estimate of the ejection fraction -all are ballpark figures, not precise measurements. Therefore, I would say your ejection fraction is somewhere between 29 and 40 percent. Whether it is 29 or 35 or 40 would not affect how I would manage you medically. I would treat you the same regardless of your exact EF - same medicines, same tests, etc.
These tests all determine which parts of the heart muscle are dead by seeing which parts do not contract.
I hope this is useful. Feel free to write back. I wish you the best of luck.
If you would like to set up an appointment with one of our cardiologists here at the Cleveland Clinic please feel free to call 1-800-CCF-CARE.
Information provided in the Heart Forum is intended for general medical informational purposes only. Actual diagnosis and treatment of any particular medical condition can only be made by your physician(s).
: FOLLOW UP

:      I seem to do well with the heart damage I have. The only problem is that I tire out quickly and am shorter of breath than before. How do I figure out what my limits are without hurting myself, What are safe limits on lifting with the damage I have? I also have a left ventrical anursyrm. Explain what this means.
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Dear James
A ventricular aneurysm refers to heart muscle that is dead and has lost its usual shape and geometric configuration. It implies a previous serious heart attack. It predisposes to clot formation in the heart, as well as to irregular heart beats.
As far as safe limits, you should check with your own cardiologist. There are no direct correlations between EF and a safe amount to lift or exercise in a given individual. Some people with an EF of 30% are totally incapacitated, while some patients with an EF of 10% are very athletic. It might be beneficial to enroll in a cardiac rehab program so that you can begin exercising in a somewhat supervised setting. You should also make sure you are seeing a cardiologist, so that he can get you on medicines to help with the shortness of breath and help the heart heal itself.
I hope this has been useful. Feel free to write back with further questions. Good luck.
Information provided here is of a general nature.  Specific diagnoses and treatments can only be made by your doctor.  If you would like to be seen at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a cardiologist at Desk F15.
Follow Up
    After my heart attack on Nov 20, 1997, I had angioplasty on Feb 5, 1998. With one blockage or 100% and one 99% was there any chance of having any viable tissue left after this much time had past? When I had the angioplasty I had no pain when the ballon was inflated, does this mean anything? I was told that if these arteries closed back off I proabaly wouldn't know it. Is a catherization the only test to tell if they are blocked off again?
     Thank you very much for your responses.
    
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Dear James
Yes, there could have been viable tissue even after that amount of time had passed.
Balloon inflations usually cause chest pain. Some patients, however, do not feel any pain; this explains how some patients can have a heart attack and not know it - a so called silent heart attack.
A catheterization is the only definitive test to see if your arteries are blocked off. A stress test can also be used to determine if there is a blood flow problem in the heart, and indirectly allows a doctor to guess whether there is a severe blockage.
I hope this is useful. Feel free to write back. I wish you the best of luck.
If you would like to set up an appointment with one of our cardiologists here at the Cleveland Clinic please feel free to call 1-800-CCF-CARE.
Information provided in the Heart Forum is intended for general medical informational purposes only. Actual diagnosis and treatment of any particular medical condition can only be made by your physician(s).