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what is a normal ejection fraction/LVH
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what is a normal ejection fraction/LVH


Thanks for taking my question. I am a bit confused as to what most cardiologist consider a normal ejection fraction, I have seen conflicting numbers though the difference being very small.

I have seen 50-70% as normal , then 55-75% as normal. What numbers or % do CCF use? Would you consider an EF of 50% and over normal?

  The reason I ask my last echo 2 months ago on the printout it showed an Ef of 53%, yet in the doctors office he said my EF was actually 55-60%, when I received a copy of the echo report it said 53%, I called and asked him about the difference in the printout and what he told me, he said my Ef was what he told me 55-60% and the number on the printout was of no significance, that I had no signs of cardiomyopathy. Even if my Ef 53% , would you still consider that normal? From what i gather most centers and cardiologist consider 50% and above normal, though I seen guidelines with the low being 55%, this is confusing,I just some clarification.

My EF 5 years was 65-70%, I understand it can vary, he told me that time I was more nervous and that my heart was a bit hyperkinetic then, Would you agree that increased anxiety with your heart punding harder , even if no that much faster can increase your EF?

I was told 5 years ago I had borderline hypertrophy at 12mm interventricular septum, now the printout shows 14mm, he told me my hypertrophy was mild, this was the only thing that was out of range on my echo, all other measurements was normal. I do push ups regularly to keep my back straight because of a CTD I have, Would this cause mild LVH? Thanx
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74076_tn?1189759432
Hi Tickertock,

Thanks for the post.  Don't get too hung up on a number -- they are just numbers.  I could look at an echo and call it 55% and the doctor next to me could say 50% or  60%.  When we quote ejection fraction we usually have the caveat +/- 5% after it.

We would call 50% low normal.  I would not worry about this.

Would you agree that increased anxiety with your heart punding harder , even if no that much faster can increase your EF?

yes, I would agree.

I do push ups regularly to keep my back straight because of a CTD I have, Would this cause mild LVH?

Push ups are not causing your LVH.  Although I am bigger advocate of aerobic exercise, a good mix of strength and aerobic training is a good thing.

I hope this helps.

23 Comments
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Avatar_n_tn
Hi.  Good question.  I've only had one echo in my lifetime and my EF was 45%.  Iwas told it was alittle below average for a 36 year old but okay.  But since I've been reading on this forum, I'm wondering.  In either case I'm having another echo in a couple of months because of high BP and a new sound (murmur?)that they picked up.

Do EF's typically go up or down as you age?  Would you know?

Regards,
marching on
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Avatar_n_tn
I was told I had indications of LVH about a year ago,and Had probablyhad this condition 15 monts or more.

it was just diagnosed by an EKG,and I have had no other tests,so don't know what is happening.I am on meds for high blood pressure,but that is about all.

I have never been able to find out what the symptoms of LVH are?

I don't feel any different than before the doctor told me.

Should I ask or insist on a echo to find out about this ejection fraction?

Thanks all
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84483_tn?1289941537
EKGs are not accurate for detecting LVH, they can give false positives, the echocardiogram is the gold standard for detecting LVH. If you really want to know have an echo , it can give you the dimensions of heart fairly accurately, your EF, and condition of your heart valves. Good luck.
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Avatar_m_tn
Does anyone know what is the best EF% in men?
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84483_tn?1289941537

That's a good one , I have seen articles that states a man's EF should be higher than a woman's, then I have read the opposite that women EF should be slightly higher than men, from what i gather this is pure theory and speculation for the most part and that whether a man or woman once your EF falls within  within the normal range it really doesn't matter. I am not a medical doctor this is my understanding only.
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Avatar_n_tn

Well, thank you everyone for your comments.

I asked my doctor about getting an echo,and he said that they only do them if they can't get blood pressure under control.

he said that the EKG indicated I had evidence of LVH, because he had it read by a cardiologist.

So, maybe I will get another opinion now.

I don't understand this line of reasoning on his part at all.

Thanks again.
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84483_tn?1289941537

When I had my echo done 5 years ago, I had the minimal voltage criteria for LVH on my EKG, so the echo was done right there in the doc's office, it only revealed borderline hypertrophy. After 5 years I got another echo 2 months ago by the same cardio, even though my EKGs , GET THIS, for the last 2 years did not suggest LVH, apparently my LVH had progressed from borderline to mild LVH, yet the EKG did not suggest this. I had suffered from mild hypertension which I considered controlled, 115/75 nearly everytime I took it at home.

Yet this time my cardio samed less concerned and told me to see him in 2 years, to be honest I hate to doubt my cardio and take the medication as directed, now my B/P is around 105/70 on average, his motto is lower the better once you don't have symptoms. I really wonder if I truly have LVH , but I don't want to second guess my cardio, but I'm seriously considering a second opinion, my heart according to him is otherwise very healthy and strong with no valve leakages or other structural abnormalities, yet I suffer from PVCs occasionally.
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Avatar_n_tn

It seems like you have had your fair share of  uncertain diagnosis too.

I was informed this weekend that an EKG done in the doctor's office is not reliable unless they have a special room The reason for this is because their is so much other electrical  interference in other offices.

It is alarming that we may or may not have LVH based on this EKG.
I hope we can all get this straightened out.
I am going to pursue this further
Good luck to you.
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Avatar_m_tn
If echo EF% measurement is dependent on heart rate than I  guess athletes will have slightly lower EF% than normal folks (eventhough their heart is in better shape and healthier)? What's your opinion on this?
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84483_tn?1289941537

Well from some articles I've read some/most athletes tend to have slightly lower EFs at rest. I know my cardio was more pleased with heart overall this time around when my he estimated my Ef to be 55-60% at 64 bpm , than 5 years ago when it was estimated to be to be around 65-75% at 77 bpm, on both occasions I was taking the same amount of beta blocker 100mg of atenolol daily in divided doses. 5 years ago I remember my heart pounding though the rate was not that fast, this time I couldn't feel my heart that much at all and was much calmer, not nervous at all.
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Avatar_m_tn
Do you know what is an average at rest echo EF% in long distance runners or other athletes? Did doctor tell you that 14mm interventricular septum  was caused by BP 115/75 (with/without drugs?
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84483_tn?1289941537

To be honest I really don't know what average rest EF in an athletes heart would be , but from the literature I have read previously from what I remember I think is between 54-63%, but I'm not certain about this.

My cardio thinks because my B/P in his office is 140/85 that my mild LVH is related to being hypertensive in stressful situations though when I take it at home its normal, Im a bit overweight so I think it might be contributing factor, he says I definitely don't have HCM, as I have no wall motion abnormalities or no obstruction, also no family history whatsoever, though I might add that both my mom and dad is hypertensive, both alive and well mom 72 and dad 77 both have LVH , EKG diagnosed , but in their case it's(EKG that is)is probably reliable.

I think I might still be within the high normal range on different views but the cardio uses the highest estimation number when measuring wall thickness and the lowest estimated number when measuring EF to err on the side of caution.

Bottomline I think my mild LVH is probably the result of prolonged mild hypertension for probably 10-15 years, had it since I was 25, now nearly 41. Overall LVH has a good prognosis though its associated with an increase in cardiac events.Hope this sheds some light on your thoughts.
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Avatar_m_tn
At some centers interventricular septum normal ranges are 8-12mm while at other 7-11mm.My cardiologist thinks as long as septum is <15mm there is nothing to worry about,especially if measurement is made at the top of septum.Folks who exercise a lot can have up to 15mm septum thicknes,but with cessation with exercise it comes down to normal.
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84483_tn?1289941537

You are absolutely correct regarding the measurement of interventricular septum. Most athletes and persons that weight lift have slightly thickened LV wall, especially of interventricular septum and I have been told the same thing regarding the thickness, once below 15mm, nothing to worry about.
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Avatar_m_tn
High-level endurance athletes have EF's of up to nearly 80%. I believe when it's higher than this it indicates other problems - but I don't recall what they are.
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84483_tn?1289941537

High endurance athletes have very high Ejection fractions at peak exercise, sometimes nearly 90%, but slightly lower EFs than non athletes at rest, at least this my understanding from the literature I read sometime ago. If I can find a site on it I'll post it. Hypertrophic Cardiomyopathy(HCM)very thickened left ventricular walls ususally due to a genetic or familial predisposition is associated with a very high ejection fraction at rest, usually walls of 20mm(2cm) or more.

Do a google search, simply type in athletes and ejection fraction in the search bar and click search, this might provide some info.

P.S. I'm very glad that you got your aneursym repaired and all is well. Keep up the good work. Best wishes and more power to you.
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Avatar_m_tn
Hello to tickertock, Lacy mary and others. This is to let you all know that I did have my 2nd high risk CABG at CCF as you all had advised. Besides replacing my damaged LIMA with the RIMA I had 4 other bypasses and all went very well. I sincerely want to thank you all and the exceptional team of cardios and surgeons at CCF. They are truly a miraculous group of professionals and may God's blessings continue to go with them. ChrisR.
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Avatar_m_tn
Does anyone know how much aerobic exercise increases EF%?
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84483_tn?1289941537

Hi Chris,

    I am so glad things worked out well for you at CCF and that your second bypass went well. Best wishes on a continued speedy recovery.
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Avatar_n_tn
Recently a friend had an echo done, showing 90% ejection fraction.  Her blood pressure was steadily dropping.  2 hours later, she coded and died.  Does anyone know what a 90% ejection fraction indicates?  Can it indicate shock?
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Avatar_n_tn
I recently had an echo done and my EF was 62% but then it has at the bottom - Fraction Short:  34%.  What does that mean?  Report says I have a normal echo but Mild left Ventricular Diastolic Dysfunction (Adnormal Relaxation).  Cath was normal.  Is there any reason for concern here?  I do take high blood pressure and lipitor.
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Avatar_n_tn
I recently had an echo done and my EF was 62% but then it has at the bottom - Fraction Short:  34%.  What does that mean?  Report says I have a normal echo but Mild left Ventricular Diastolic Dysfunction (Adnormal Relaxation).  Cath was normal.  Is there any reason for concern here?  I do take high blood pressure and lipitor.
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A related discussion, Low ejection factor was started.
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