Ejection fraction and ESV

[sonymich]

My EF is 80% and ESV 8ml. Can you please explain this? I have mild MVP with regurgitation and CAD with 2 LD 50% blockages. I have been getting very fatiqued, short of breath with exertion. At night, my heart pumps very hard. I have bouts of tachycardias "at rest", 2-3 times monthly. During these episodes, I feel very fatigued, have nausea and my bp rises. I have been having more frequent pvc last few days with a strange throat feeling. My last EKG indicated poor r wave progression v1 to v3, sinus tachycardia, non specific ST changes, no acute injury pattern. I passed my last stress test last week. What in the heck is going on with me? There are some days I feel completely out of breath with exertion. The ER Dr could hear a mild systolic murrmur on left sternal border. Normal s1 s2, question of s4. I was in hospital a few days, passed stress test and they let me go.

[kenkeith]

QUOTE: "The great news is that your ejection fraction is crazy good at 80% which basically means how strongly the blood is pumping in and out of the heart."

>>>>>Forgive me. Sorry to disagree with last poster again but a very high EF is not crazy good :)

For an explanation normal EF is approx. 50 to 70% and within that normal range the heart  maintains a balance of blood flow between the left and right side of the heart....blood going to the lungs and oxygenated blood pumped into circulation. What comes into play is the Frank/ Sterling mechanism phenomonon that helps the heart to increase or decrease CO with varying heart rate, and blood pressure that compensate each other to maintain a balance of blood flow.  Any of these factors out of their normal range for a period of time can result in over compensation and that indcates an underlying cause that should be treated.

Continuing, when the heart is pumping into circulation more than 70% with each stroke that indicates the heart has dilated to increase the CO.   The dilation effectiveness or lack thereof can be explained by the Frank/Starling mechanism and with an analogy of a hand spring....stretch the spring and there is a more forceful recoil, but over stretch the spring, and it becomes flaccid.

An individual may be in the compensated phase of mitral regurgitation (or other causes) for years, but will eventually develop left ventricular dysfunction, the hallmark for the chronic decompensated phase of mitral regurgitation. There could be other causes than mitral valve insufficiency, but the underlying cause should be treated. In this phase due to F/S phenomonon the ventricular myocardium is no longer able to contract adequately to compensate for the volume overload of mitral regurgitation (volume overload can be do to other causes), and the stroke volume of the left ventricle will decrease. The decreased stroke volume causes a decreased forward cardiac output and an increase in the end-systolic volume dilates left ventricle. And the increased end-systolic volume translates to increased filling pressures of the left ventricle and increased pulmonary venous congestion causing symptoms of congested heart failure.

You should have an echocardiogram to determine left ventricle size and degree of MVR. Hypercardiomyopathy can have many causes and can be successfully treated. I'm surprised you haven't been scheduled for more tests or maybe there has been scheduled.  If there is hypercardiomyopathy and there doesn't appear to be any decompensation which is a good indication the condition hasn't advanced.

Thanks for sharing, and if you have any further questions or comments you are welcome to respond. Take care

[cindy707]

The great news is that your ejection fraction is crazy good at 80% which basically means how strongly the blood is pumping in and out of the heart.  The ESV is just another measurement that is used for a particular ventricle which in most cases is the measurement of the left vent. it also measure cardiac output.  For a personal opinion my money would be on the episodes of tach that you are going thru that is making you so tired and a little sick to your stomach along with your b/p raising.  I hope that someone put you on a holter monitor for at least 30 days once you left the hospital to try to catch the episodes however no matter how this plays out you need to make sure that you contact the doc that ordered your tests and let them know what is going on with you so that they can nip this in the bud.  It would not be abnormal to feel a little strange in the throat region because our carotid artery runs directly thru that area of our body and it is a direct line to the heart.....letting you go from the hospital is all fine and good but why be discharged if you have not been given a final diagnosis by the docs is my question.  I would call the doc first thing in the morning and let them know what the heck is going on with you especially if you are getting out of breath during any exertion because that is a red flag in anyones book...sounds like you need answers and solutions to me....