L
luvwinnie
Just wondering HOW this is determined...can they tell this by an echo? Thank you.
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L
luvwinnie
Never mind, my friend found out her ejection fraction is 86%.
ALCapshaw2
Well-known member
The simplest way to determine Ejection Fraction (EF) is with an echo. I 'believe' that the normal range is 55 to 75%. I've never heard of anyone having 85%. That is incredibly good (or an erroneous reading).
'AL'
'AL'
The EF is reckoned by the tech, and is probably the least accurate reading from an echo report, as the input to the equation is hard to determine.
Although it's possible, your friend likely doesn't actually have an 85% EF, as Al pointed out. However, the indication is at least that his/her EF is excellent. << edit, 8/20/04, RDH: This was an ignorant statement on my part. High EFs do have a meaning, and generally it is not a good one. Still learning, Bob H>>
If it's not low, it's OK. <<this one, too. RDH.>> Of course, the question of relevency must come up. Mine was still judged as over 70% just before I went in for surgery...
Best wishes,
Although it's possible, your friend likely doesn't actually have an 85% EF, as Al pointed out. However, the indication is at least that his/her EF is excellent. << edit, 8/20/04, RDH: This was an ignorant statement on my part. High EFs do have a meaning, and generally it is not a good one. Still learning, Bob H>>
If it's not low, it's OK. <<this one, too. RDH.>> Of course, the question of relevency must come up. Mine was still judged as over 70% just before I went in for surgery...
Best wishes,
M
Mary
If it's not low, it's OK. Of course, the question of relevency must come up. Mine was still judged as over 70% just before I went in for surgery...
Gee, Bob.
In everything you've posted, I think that's the first time I heard the over 70% figure. I've been relying on my high EF to postpone surgery.
NOW YOU TELL ME!
Mary
Gee, Bob.
In everything you've posted, I think that's the first time I heard the over 70% figure. I've been relying on my high EF to postpone surgery.
NOW YOU TELL ME!
Mary
L
luvwinnie
Oh, no, I just found this:
EF higher than 75 percent could indicate a heart condition like hypertrophic cardiomyopathy.
EF higher than 75 percent could indicate a heart condition like hypertrophic cardiomyopathy.
Luvwinnie,
That would have to be coupled with enlargement of the heart, which is the "hypertrophic" part. Hopefully, your friend doesn't have that to any large degree.
Mary,
The 70%+ was from three months before surgery. As it was so good, I liked to think it was in my favor, too. Estimates for EF do vary a lot from tech to tech, but even a good one doesn't really seem to be an indicator to wait for surgery. A number of other folks had real good EFs when they went in, too. I will look mine up when I get home, to be sure I'm not fabricatin' a story, here.
It turned out I was actually overdue for the surgery, as the valve was worse than any of them had thought. I blame heavy calcification as the randomizing factor that made it worse than they had detected, even with the catheteriztion. That is one of the reasons that I point to it when it's a known agent for a person.
Best wishes,
That would have to be coupled with enlargement of the heart, which is the "hypertrophic" part. Hopefully, your friend doesn't have that to any large degree.
Mary,
The 70%+ was from three months before surgery. As it was so good, I liked to think it was in my favor, too. Estimates for EF do vary a lot from tech to tech, but even a good one doesn't really seem to be an indicator to wait for surgery. A number of other folks had real good EFs when they went in, too. I will look mine up when I get home, to be sure I'm not fabricatin' a story, here.
It turned out I was actually overdue for the surgery, as the valve was worse than any of them had thought. I blame heavy calcification as the randomizing factor that made it worse than they had detected, even with the catheteriztion. That is one of the reasons that I point to it when it's a known agent for a person.
Best wishes,
S
Susan BAV
My Ef was very high also, 75% or so as I recall, a few months before my valve replacement, as per an echo. I also have left ventricular (ventricle?) hypertrophy (LVH), which could possibly have developed from years of severe hypertension, and my father had hypertrophic cardiomyopathy (which used to be referred to as IHSS but has different initials now), which his doctors were concerned I might develop. Oh boy . I may be a little unusual, however, because most of the AVR patients that I've read about here have low blood pressure, not high.
. I may be a little unusual, however, because most of the AVR patients that I've read about here have low blood pressure, not high.
S
Susan BAV
Oh, and my hypertension is completely gone, post-op!!!
My echo EF at three months before surgery was listed at 77%. The day before surgery, the catheterization listed my EF as 55%. Five weeks after surgery, my EF was listed as 60%.
Four years before the surgery, they simply state that, "there is normal ventricular wall motion with a high ejection fraction." Another echo taken in 2000 doesn't mention an Ejection Fraction at all. I was younger: maybe back then it was a whole number...
Confusing, neh? I think it is a highly subjective estimate.
If you have hypertrophic cardiomyopathy, your ejection fraction is displaced so badly that I wonder if it may be irrelevant.
Otherwise, we're looking for 55%+ as normal. See? Sometimes it is good to be over 55...
Best wishes,
Four years before the surgery, they simply state that, "there is normal ventricular wall motion with a high ejection fraction." Another echo taken in 2000 doesn't mention an Ejection Fraction at all. I was younger: maybe back then it was a whole number...
Confusing, neh? I think it is a highly subjective estimate.
If you have hypertrophic cardiomyopathy, your ejection fraction is displaced so badly that I wonder if it may be irrelevant.
Otherwise, we're looking for 55%+ as normal. See? Sometimes it is good to be over 55...
Best wishes,
S
Shine_on_Syd
I just got my echo results back (16 months post op) and my EF was 64%. My doc said he wouldn't want it much higher than that.
My EF was 55 pre op and I was told that was "good"
My EF was 55 pre op and I was told that was "good"
Ejection Fractions: The Cheap Tour
Ejection Fractions: The Cheap Tour
OK, OK, so I have a study assignment for tonight...
Here's the Cheap Tour on Ejection Fractions (EF), as I understand it:
Your ejection fraction (EF) is the percentage of blood that's pumped out of the chamber in question during a heartbeat. For AVR purposes (and as found in most echo reports), the chamber used would be the left ventricle.
For example, if 30% of the original blood is left in the left ventricle after the heart beats, then your EF is 70%.
Oxygen-rich blood from the lungs goes through the pulmonary veins. The pulmonary veins empty into the left atrium, which acts as a collecting reservoir.
The first part of the heartbeat squeezes the left atrium, pushing most of that blood reservoir into the left ventricle through the mitral valve, filling it. Then the mitral valve closes to keep the blood from flowing back.
The second part of the heartbeat causes the left ventricle to squeeze that blood out through the aortic valve into the aorta. The aorta then disperses it to the brain, heart, and body.
That is what is being measured by the ejection fraction: the percentage of the blood from the left ventricle that gets pushed out into the aorta through the aortic valve.
The range to look for as normal is 55% to 75%. Reduced cardiac function is in the range of 40% to 55%. An EF below 40% means that the heart is weak, and may well indicate a condition like chronic heart failure (CHF), where the heart can't pump hard enough to supply the body well. EFs above 75% can indicate cardiac hypertrophy (heart enlargement or thickening) or other problems.
The EF numbers on an echo report are estimates, and their accuracy can be subjective and variable.
That's the EF skinny, so if you're tired, stop here. More related information:
Note here that what is happening on the left side is mirrored on the right side, with the following differences: the blood is oxygen-depleted, and comes in through the vena cava; the tricuspid valve does the function of the mitral valve; the pulmonary valve does the function of the aortic valve, and the blood is going out to the lungs via the pulmonary artery, to pick up oxygen. In the classic lub-dub, the lub is the atriums, and the dub is the ventricles.
What affects the EF? Several things. The most important are the heart muscles themselves, meaning whether they can efficiently push the blood out into the body, and the condition of the two valves involved. Some prescription drugs can also cause an artificially high EF.
If the aortic valve is restricted (stenotic), the effort to push enough blood through it in one beat may be greater than the heart can manage in its normal state. If the aortic valve leaks (regurgitates), some of what gets pushed out to the aorta leaks back into the ventricle, undoing the work that the squeezing heart muscle has done.
If the mitral valve is stenotic, the ventricle may not be able to fill all the way during a heartbeat in its normal state. So there is not enough blood in the ventricle to push out to the aorta during a beat. If the mitral valve leaks, some of the blood is pushed out into the aorta by the ventricle, but some also leaks back into the atrium. Again, the aorta is not filled.
The aorta disperses the blood to the brain, heart, and body. When it isn't fully engorged with blood by a heartbeat, the partial failure is called aortic insufficiency. This can lead to syncope (dizziness or fainting), shortness of breath (SOB), fatigue, or other symptoms of low blood flow.
Any of these stenoses or regurgitations can cause enlargement of the heart muscles, as they grow to compensate for the increasing effort required. As they grow, the chambers change with them. Paradoxically, the new chambers and stiffer chamber walls caused by the heart muscle growth are less efficient for pushing blood out. This can cause the heart muscles to grow more. You can see where this is going. The growth is called hypertrophy. The process of decline is called a myopathy.
A little thick for reading, but I tried. As always, please correct me if you spot errors, as I don't wish to misinform.
Best wishes,
Ejection Fractions: The Cheap Tour
OK, OK, so I have a study assignment for tonight...
Here's the Cheap Tour on Ejection Fractions (EF), as I understand it:
Your ejection fraction (EF) is the percentage of blood that's pumped out of the chamber in question during a heartbeat. For AVR purposes (and as found in most echo reports), the chamber used would be the left ventricle.
For example, if 30% of the original blood is left in the left ventricle after the heart beats, then your EF is 70%.
Oxygen-rich blood from the lungs goes through the pulmonary veins. The pulmonary veins empty into the left atrium, which acts as a collecting reservoir.
The first part of the heartbeat squeezes the left atrium, pushing most of that blood reservoir into the left ventricle through the mitral valve, filling it. Then the mitral valve closes to keep the blood from flowing back.
The second part of the heartbeat causes the left ventricle to squeeze that blood out through the aortic valve into the aorta. The aorta then disperses it to the brain, heart, and body.
That is what is being measured by the ejection fraction: the percentage of the blood from the left ventricle that gets pushed out into the aorta through the aortic valve.
The range to look for as normal is 55% to 75%. Reduced cardiac function is in the range of 40% to 55%. An EF below 40% means that the heart is weak, and may well indicate a condition like chronic heart failure (CHF), where the heart can't pump hard enough to supply the body well. EFs above 75% can indicate cardiac hypertrophy (heart enlargement or thickening) or other problems.
The EF numbers on an echo report are estimates, and their accuracy can be subjective and variable.
That's the EF skinny, so if you're tired, stop here. More related information:
Note here that what is happening on the left side is mirrored on the right side, with the following differences: the blood is oxygen-depleted, and comes in through the vena cava; the tricuspid valve does the function of the mitral valve; the pulmonary valve does the function of the aortic valve, and the blood is going out to the lungs via the pulmonary artery, to pick up oxygen. In the classic lub-dub, the lub is the atriums, and the dub is the ventricles.
What affects the EF? Several things. The most important are the heart muscles themselves, meaning whether they can efficiently push the blood out into the body, and the condition of the two valves involved. Some prescription drugs can also cause an artificially high EF.
If the aortic valve is restricted (stenotic), the effort to push enough blood through it in one beat may be greater than the heart can manage in its normal state. If the aortic valve leaks (regurgitates), some of what gets pushed out to the aorta leaks back into the ventricle, undoing the work that the squeezing heart muscle has done.
If the mitral valve is stenotic, the ventricle may not be able to fill all the way during a heartbeat in its normal state. So there is not enough blood in the ventricle to push out to the aorta during a beat. If the mitral valve leaks, some of the blood is pushed out into the aorta by the ventricle, but some also leaks back into the atrium. Again, the aorta is not filled.
The aorta disperses the blood to the brain, heart, and body. When it isn't fully engorged with blood by a heartbeat, the partial failure is called aortic insufficiency. This can lead to syncope (dizziness or fainting), shortness of breath (SOB), fatigue, or other symptoms of low blood flow.
Any of these stenoses or regurgitations can cause enlargement of the heart muscles, as they grow to compensate for the increasing effort required. As they grow, the chambers change with them. Paradoxically, the new chambers and stiffer chamber walls caused by the heart muscle growth are less efficient for pushing blood out. This can cause the heart muscles to grow more. You can see where this is going. The growth is called hypertrophy. The process of decline is called a myopathy.
A little thick for reading, but I tried. As always, please correct me if you spot errors, as I don't wish to misinform.
Best wishes,
L
luvwinnie
wow, thanks everyone!
After some research my friend discovered that having too much thyroid hormone can cause LVH! And she had this problem which is being fixed with a medication dosage adjustment.
After some research my friend discovered that having too much thyroid hormone can cause LVH! And she had this problem which is being fixed with a medication dosage adjustment.
M
Mary
I guess we will agree that my calculated EF of 88% is either inflated or something is seriously amiss!
Mary
Mary
I hate when that happens...
I hate when that happens...
Sincere thanks to dcpickle for pointing out a rather horrendous switching of the terms ventricle and atrium in the above (since corrected). Sometimes terms get trapped in the weird logic of writing, cease to have meanings, and become only patterns, easily reversed. Mea culpa.
Mary, it seems to me that there are several possibilities to consider. It may be a poor echo report estimate. Or it may be related to a prescription you take (are you taking anything intended to improve heart function?). Or it may be due to some enlargement of your left ventricle.
Best wishes,
I hate when that happens...
Sincere thanks to dcpickle for pointing out a rather horrendous switching of the terms ventricle and atrium in the above (since corrected). Sometimes terms get trapped in the weird logic of writing, cease to have meanings, and become only patterns, easily reversed. Mea culpa.
Mary, it seems to me that there are several possibilities to consider. It may be a poor echo report estimate. Or it may be related to a prescription you take (are you taking anything intended to improve heart function?). Or it may be due to some enlargement of your left ventricle.
Best wishes,
H
Harpoon
So basically, it's how much (percentage-wise) blood from one chamber is flowing into another chamber. High numbers are good, low are bad, correct?
I've heard (I think) that a better measuring of the EF can be determined either through a mugga scan (explained somewhere else in another thread) and/or a cath. Yes/no?
Just to set it all straight.
I don't know what my numbers were/are/should be... I know an artifical valve allows less blood to flow through the valve than a heart healthy, natural valve, though that number is getting better as technology improves.
I know that older style valves have poorer EF's than the new valves out on the market and even then, some valves are better than others.
I also know, aparently, one company is using the "quietness" of it's artificial heart valves as a selling point which I think is TOTALLY rediculous!
You don't choose a valve because it's harder to hear, you choose a valve because it works well and will outlast you.
Right?
Slap me if I'm wrong, I need that every once in a while and I'm more often wrong than right sometimes....
???
Rare form tonight, I shot all day and got some sunburn and watched a car back into a parked ambulance twice because he didn't hit it hard enough the first time. He then attempted to leave the scene of the accident...
This happened right in front of a pair of NYS Troopers who were waiting to do traffic control for a convoy of truckers and fire engines whould would be giving rides to handicapped children....
I've heard (I think) that a better measuring of the EF can be determined either through a mugga scan (explained somewhere else in another thread) and/or a cath. Yes/no?
Just to set it all straight.
I don't know what my numbers were/are/should be... I know an artifical valve allows less blood to flow through the valve than a heart healthy, natural valve, though that number is getting better as technology improves.
I know that older style valves have poorer EF's than the new valves out on the market and even then, some valves are better than others.
I also know, aparently, one company is using the "quietness" of it's artificial heart valves as a selling point which I think is TOTALLY rediculous!
You don't choose a valve because it's harder to hear, you choose a valve because it works well and will outlast you.
Right?
Slap me if I'm wrong, I need that every once in a while and I'm more often wrong than right sometimes....
???
Rare form tonight, I shot all day and got some sunburn and watched a car back into a parked ambulance twice because he didn't hit it hard enough the first time. He then attempted to leave the scene of the accident...
This happened right in front of a pair of NYS Troopers who were waiting to do traffic control for a convoy of truckers and fire engines whould would be giving rides to handicapped children....
H
Harpoon
I should have bought stock in Google while the auction was going....
Is it still????
Found this:
Summary
An ejection fraction (EF) is one of the measurements used by physicians to assess how well a patient?s heart is functioning. ?Ejection? refers to the amount of blood that is pumped out of the heart?s main pumping chamber during each heartbeat. ?Fraction? refers to the fact that, even in a healthy heart, some blood always remains within this chamber after each heartbeat. Therefore an ejection fraction is a percentage of the blood within the chamber that is pumped out with every heartbeat. An EF of 55 to 75 percent is considered normal. A higher than normal ejection fraction could indicate the presence of certain heart conditions, such as hypertrophic cardiomyopathy. A low ejection fraction could be a sign that the heart is weakened.
An EF below 40 percent may be present in heart failure or some types of cardiomyopathy. Heart failure is a condition in which one of the heart?s pumping chambers is not pumping well enough to meet the body?s needs. Cardiomyopathy is a condition in which the heart is abnormally enlarged, thickened.
http://www.heartcenteronline.com/myheartdr/common/articles.cfm?ARTID=609
Is it still????
Found this:
Summary
An ejection fraction (EF) is one of the measurements used by physicians to assess how well a patient?s heart is functioning. ?Ejection? refers to the amount of blood that is pumped out of the heart?s main pumping chamber during each heartbeat. ?Fraction? refers to the fact that, even in a healthy heart, some blood always remains within this chamber after each heartbeat. Therefore an ejection fraction is a percentage of the blood within the chamber that is pumped out with every heartbeat. An EF of 55 to 75 percent is considered normal. A higher than normal ejection fraction could indicate the presence of certain heart conditions, such as hypertrophic cardiomyopathy. A low ejection fraction could be a sign that the heart is weakened.
An EF below 40 percent may be present in heart failure or some types of cardiomyopathy. Heart failure is a condition in which one of the heart?s pumping chambers is not pumping well enough to meet the body?s needs. Cardiomyopathy is a condition in which the heart is abnormally enlarged, thickened.
http://www.heartcenteronline.com/myheartdr/common/articles.cfm?ARTID=609
S
Susan BAV
Harpoon said:
That kind of reminds me of something, kind of reverse but equally ridiculous, that was on the local television news several years ago. A police suspect for some kind of crime was shot (not badly) and was lying in a parking lot. The news camera caught the ambulance that was called to help the guy BACKING OVER the criminal's leg
... and at that point, the ambulance driver was so terribly rattled for having driven over the man that he PULLED FORWARD to get off the man... But his tire had already passed OVER the guy's leg once, right... so he ended up driving over the guy's leg a SECOND TIME ! I'll bet the guy sued somebody big time! Is that an example of crime paying ?!
H
Harpoon
"Is that an example of crime paying ?!"
Only if you discount having your leg ran over TWICE by a big ambulance....
Dunno, maybe he just broke out even on the deal.
Chances are, if he was guilty, the state (through the prison system) paid most, if not all of his medical expenses, at least for rehabilitation....
And if the ambulance was connected to a municiple fire department, the state (or at least local government) paid even more for the initial injuries.
Then there's whatever lawsuit the guy might have been able to bring to bear agaisnt the driver and whomever else.
It's a big of a stretch, but maybe the criminal even tried to sue the police department for shooting him in a parking lot where he could have been run over by a passing motorist.
Is that a frivolous suit or not???
Only if you discount having your leg ran over TWICE by a big ambulance....
Dunno, maybe he just broke out even on the deal.
Chances are, if he was guilty, the state (through the prison system) paid most, if not all of his medical expenses, at least for rehabilitation....
And if the ambulance was connected to a municiple fire department, the state (or at least local government) paid even more for the initial injuries.
Then there's whatever lawsuit the guy might have been able to bring to bear agaisnt the driver and whomever else.
It's a big of a stretch, but maybe the criminal even tried to sue the police department for shooting him in a parking lot where he could have been run over by a passing motorist.
Is that a frivolous suit or not???
M
medtronic of borg
left hypertrophic cardiomyopathy
left hypertrophic cardiomyopathy
This is my beast...my ef at last echo was 42 as high as it has ever been. It has been as low as 18 when they put in the new valve bringing it up to 32. I'd be intrested to know if anyone out there with lhcm ...ef numbers have been?
Medtronic of borg
left hypertrophic cardiomyopathy
This is my beast...my ef at last echo was 42 as high as it has ever been. It has been as low as 18 when they put in the new valve bringing it up to 32. I'd be intrested to know if anyone out there with lhcm ...ef numbers have been?
Medtronic of borg
