Ejection Fraction getting worse

[FamDoc]

My husband was diagnosed with idiopathic dilated cardiomyopathy in February 2014.
His ejection fraction was 35%.
He took a beta-blocker and an ace-inhibitor since and in June his echo numbers improved, including his ejection fraction to 37%.
From July until now he participated in Cardiac rehab, doing 3 miles in 60 minutes.
He feels well, no chest pain, shortness of breath or palpitations.
Last week he had another echo and was told that his ejection fraction is worse=27% and his left ventricle is more dilated.
he had another echo yesterday at another lab and they show his ejection fraction as 38%. This is a big difference.
I have two questions 1. Whom should we believe?  2. Is it possible that the cardiac exercise was too strenuous and made his heart condition worse?
Thank you so much for your time.

[ed34]

Ask for an MRI of his heart, to get a more accurate EF. Either that, or ask them to use contrast during the echo. I agree that a high level of exercise will not help too much.

[Jerry_NJ]

I agree.

Echocardgrams are estimates at best and comparison is best if done by same operator on the same equipment.

Nonetheless, even the best EF number is very low.  I do not have any knowledge about ways to increase EF, or even if that is possible.

It may be that an angiogram (heat catheter) can provide an accurate EF, but the consensus of the data you have says, low.

[njean]

I would be looking for a 2nd opinion and for another cardiologist.  I personally would not have been doing that much cardiac exercise if my EF was at 37%!  

Echo's can vary from tech to tech and lab to lab and they don't always give the true picture of what is going on.  A Heart Cath tells the true story.  

I have a friend who had a cardiologist that told him that his Echo showed 32% EF and that he needed to have an ICD implanted or he was going to die.  My friend did not take this doctor's word and went to seek another opinion from another cardiologist and come to find out, they did a cath & his EF was at 52% and he did not need the implant!  He changed cardiologist's immediately and his old cardiologist was none too happy to see that!

Be pro-active and request further testing or go to another cardio.  It's your life so if your gut feeling is telling you something else, follow your instincts!

Wishing you the best of luck!