Very Different EF Numbers from Echo and Nuc Med Scan

Question

I am a 73 yo male, normal weight and get adequate exercise. I was given an Echocardiogram on Dec 31, 2014 because of some minor arrhythmia. I have had no other issues or symptoms. EF from the Echo was 30-35%: Moderate-severe left ventrical systolic dysfunction. The findings also said "the study quality was fair and "technically limited due to patient body habitus" and concluded it was a "technically difficult study, confounded by occasional ectopy".

I was traveling and didn't receive these results until mid March when my cardiologist recommended I quit drinking (never more than 1-2 drinks per day) and ordered a nuclear stress test which I did on April 2 (90 days after the Echo). I had no drinks for 2 weeks prior to this test. Nothing else changed. This test showed my post-stress/rest EF at 74/75%: Myocardial perfusion and left ventricular contractility normal. I'm not complaining, but this huge EF difference makes no sense to me and doesn't seem feasible. My cardiologist had no answer for the difference. I will have a follow-up appointment in 6 mo. Can I assume the Echo was incorrect? Is there something else I should do?

Thank You in Advance,
Geo.

ed34 · Answer

It's the nature of such scans unfortunately. As flycaster says, the best figure is given by angiogram and everything else is an estimate which can be far off.

Ger57 · Answer

You say you get adequate exercise. Do you feel much better now, with increase exercise capability compared to december when they did the echo?

Ger57 · Answer

Much tissue between the probe and the heart makes interpretation more difficult but even if that is not the case and the quality of the echo images is classified as "good", EF fraction is still a rough estimate (as many other measurements).

Flycaster305 · Answer

The most accurate test would be an angiogram.

Occupant · Answer

Yes, I had a similar result three years back, Echo: 55%, Nuclear Scan: 70%. They always say "technically limited" when they are really saying: "You are too fat" Sorry, if that should offend you, but that remark was really more directed at myself since my report said the same thing. I would guess, the more the Echo is "technically difficult" the higher the inaccuracy. I had no follow up in these three years.