Echocardiagram

[Marge]

Last month had an echocardiagram -- for first time this year.
I had an echo around this time last year & my cardio also had me do a MUGA and a TEE. Last year's echo had showed an EF of 30. The MUGA showed an EF of 53 -- low normal but still normal. Big discrepancy, but, cardio advised, MUGA is more accurate, and echo is notoriously subjective, yada, yada. So I felt pretty good about that 53 EF.
BUT: now my cardio calls me to tell me this year's echo again shows an EF of 30-35!
Even given subjectivity of echos, that's two in a row with more or less same EF.
Cardio doesn't want to run any more tests now. He says maybe another MUGA next year; for one thing, he says MUGAs are very high in radiation.
About the EF he is saying that he had hoped mine would improve from the treatment (all that consists of is Cozaar for blood pressure and a beta blocker, Coreg) & so he is disappointed -- but he then says that he looks more at "trends" than at the numbers themselves. Since I am not going "down," he isn't too worried (and by extension I shouldn't be either). He said he has patients that have gone along for 10-15 years with EFs of 30 & have led perfectly satiafying lives, not going into CHF.
The good thing is that I have felt perfectly fine since my surgery -- the funny thing is that I felt perfectly fine BEFORE the surgery too! -- so I just try not too think about all this too much.
But I'd like to think my EF wasn't that low!
When I ask my cardio how to reconcile that two echos in succession say 30 while the MUGA said 53 -- are both echos that subjective? -- my cardio shrugs and says all he can say, really, is that I am "somewhere" between 30 and 53.
(Haven't yet seen full text of echo report so I don't know what else it showed.)

 

[PJmomrunner]

Hi Marge:

What's the sense in learning an inaccurate EF? I understand the echo is a great tool for assessing the condition of the valves, the size of the chambers, etc..., but if it's not useful in determing EF and knowing EF is important, then do another MUGA. This article says it delivers as much radiation as a chest xray:

http://heartdisease.about.com/cs/cardiactests/a/muga.htm

30% is pretty crappy. 53% is pretty normal. Which is it???

 

[Marge]

Hi Marge:

What's the sense in learning an inaccurate EF? I understand the echo is a great tool for assessing the condition of the valves, the size of the chambers, etc..., but if it's not useful in determing EF and knowing EF is important, then do another MUGA. This article says it delivers as much radiation as a chest xray:

http://heartdisease.about.com/cs/cardiactests/a/muga.htm

30% is pretty crappy. 53% is pretty normal. Which is it???

That's interesting -- my cardio quoted me radiation figures for the MUGA that were higher. Can't remember the exact figure. I'll have to talk to him about it.
Of course one reason he doesn't want to do it may be because this is Kaiser & it is supposedly an expensive test. (People I've talked to about it have been surprised I even had it done once. I think it was because I really really bugged my cardio after last year's echo.)
I don't know what else the echo shows besides the EF because I only talked to the cardio over the phone & I have not seen the report. He is supposed to be mailing it to me. I'm leaving on vacation very early tomorrow so may not get to see it until next month. When I get back, I'll call him and make an appointment.
All I can say is that I FEEL more like a 53% than what I imagine a 30% feels like!

 

[ClickerTicker]

Marge, I wouldn't get too worked up about the EF. Since my op, my LVEF has been measured by echo at between 10 and 20. Most recent was 20. Doesn't seem to affect me at all. Can still comfortably do a 30 mile cross country walk in a day.
There seems to be a fair bit of subjectivity about measuring the EF - not surprising when you look at an echo and see everything moving around.
Of course your mileage may vary - I can only speak from my own experience and I've never had a MUGA, only an echo. Best of luck (btw, isn't the TEE horrid )

 

[Nancy]

What did the TEE have to say?

 

[Marge]

I can't remember the details of the TEE. That versed is powerful! I know the interventional cardio told me the valves were OK. Apparently my valve repair was quite successful ..... That reminds me, I should get make an effort & get the report from the TEE.
Anyway, I am going to go on vacation tomorrow and just not think about all this for 10 days. Thanks for all the help.