Re: ejection fraction

Posted By CCF CARDIO MD - MTR on March 10, 1998 at 14:22:36:

In Reply to: ejection fraction posted by sharon joyner on March 09, 1998 at 13:35:39:







: My husband experienced a disabling heart attack on 2-2-97.  We are in the
process of filing for social security disability on the advice of his
doctors(cardiovascular and pulmonary).  The ejection fraction looks very
good at this time(57)however this in no way reflects his ability when he
is active and a stress test is not an option for him.  
Is literature available that shows heart funtion can be
significantly different when a person tries to do normal task? Multiple
problems are involved.  I need factual information to submit to the
social security administration.   Thank you






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Sharon, thank you for your question.  Your question is difficult to answer but I'll try
to provide some insight for you.  After a heart attack, the heart muscle is weakened and
sometimes can be irreversibly damaged if prompt therapy isn't given at the beginning
to restore blood flow past the clot in the coronary artery that caused the heart attack.
After a heart attack, doctors routinely evaluate the pumping function of the heart with
a variety of tests that all provide an ejection fraction (EF).  The EF measures how
efficiently the heart pumps blood and is normally > 55%.  The EF is a powerful predictor
of prognosis after a heart attack and portends a worse prognosis when it's less than 35%.
In your husband's case, his EF is preserved but that doesn't deny that other things may be
going on.  I wonder if he has chronic lung disease (he has a pulmonary doctor) that may
have limited his functional capacity prior to the heart attack.  You mention that he has
more symptoms with activity and that a stress test is not an option for him.  With severe
coronary disease, angina and fatigue can limit exercise capacity.  After a heart attack,
patients usually undergo stress testing and as well as cardiac catheterization to determine
where the coronary arteries have blockages.  Without the information from a stress test,
it's difficult to determine your husband's functional capacity and what his long-term
prognosis is.  If your husband (with a normal ejection fraction)is so limited by angina
or other symptoms that he cannot donormal activities, then he requires a further
evaluation and may need a cardiac catheterization to determine if angioplasty or coronary
artery bypass grafting could help.  I think that would be necessary before determining
whether he's eligible for disability.  As for available literature, I would need more
information to point you in that direction.  I suggest that you meet with your husband's
physician to go over these issues and to more carefully address the issue of disability.
Information provided in the Heart Forum is for general purposes only.  Specific diagnoses
and therapies can only be provided by your physician.