Echo report

[caterb85]

I was just wondering if anyone could help me with my husbands echo report. It said his ejection fraction was 71, i heard that normal is 60 to 70 . Also it said he had mild pulmonary hypertension, what does this mean? Please help in any way you can, it will greatly appreciated. Thanks so much cathy

 

[Adrienne]

The high ejection fraction actually means that in a sense his heart is over-compensating. The problem with this is that it is probably at a point that if something is not done soon, the EF could start plunging.

As for pulmonary hypertension, there are people here who know more about it than myself. I do know that it is not good. Since it is mild, if he gets the needed surgery, probably things will turn out alright.

I would certainly talk about this with his cardiologist.

 

[Adrienne]

Sorry, I just saw in the profile that he has already had surgery. I still think he should ask about the high EF and the mild hypertension.

 

[Bina]

Postop I had an EF of 69% which I attributed to my heart still needing more time to remodel and become more efficient again.
Sorry I don't know anything about the mild PH.

 

[caterb85]

Thanks

Thanks

Thanks for your replies the cardiologist said everything looked good. I don't know why he said this with elevated fraction and mild pulmonary hypertension? If anyone else out there CAN educate me more on these two subjects i would greatly appreciate it. Thanks again cathy

 

[ALCapshaw2]

Nancy is our 'resident expert' on Pulmonary Hypertension.

You can find LOTS of discussion of this subject by doing a SEARCH (see the Blue Line at the top of the page) and typing in "Pulmonary Hypertension" as the keyword.

To do an extented search, you will need to go to the bottom of the search page and select "anytime" instead of the (short) default.

The 'problem' with using 'standard values' as a reference guide is that values that are in or near the limits are often dismissed as "normal" or "near normal" when in fact there may have been significant change (i.e. Low Normal to High Normal) that is often completely overlooked. Do you have any Earlier Echo Reports that you can refer back to which show lower Ejection Fraction(s)?

If you don't already keep copies of your husband's test reports, I highly recommend getting copies for your own files. I chart my Echo Reports on a spread sheet which makes it Easy to spot Changes.

 

[Bina]

Cathy, my cardio almost automatically says that "everything looks fine."
My EF was always 60% before OHS, then last year it was 69%.
Maybe my next one will be very different again, who knows.....

 

[caterb85]

Bina

Bina

Thanks it sure does help to talk to people who have been through this thing and know what i'm talking about. Also i did mention to the doctor that during the echo the tech showed us above the mitral valve it look like bubbles going up, she said tht it was either a broken blood vessel or a cord which she did'nt think it was. We asked the cardio dr but he did not know what we were talking about. Did you ever hear of this?

 

[tobagotwo]

The "PATs" you discuss in the profile are probably PACs, which are Premature Atrial Contractions. They are not generally problematic, although they can feel annoying.

Echoes are often a bit off on the ejection fraction. However, it's likely still high from the presurgical issues. As his heart remodels, it should lower some.

The cord described is probably actually one of the "chordae," which is a cord that tethers part of the mital valve to a muiscle on the valve wall. The mitral valve is somewhat like a parachute, and there are many chordae that tether it.

An echo is a highly unreliable method for determining PH. If there is genuine concern, a right heart cath is the accurate method for that diagnosis. There are treatments. It's important to know whether it's still Secondary Pulmonary Hypertension from the prior valve issues, or if it's Primary PH. PPH stays with you, but is treatable. Al Capshaw is right: Nancy is the most knowledgeable on the site of whom I am aware.

Note that the high EF and PH readings may be a technician issue. I wouldn't rule out having an echo done independently. Do not supply prior echo results to the "check tech," as some seem to anticipate findings from them.

Note: these terms are locatable in the Glossary: http://www.valvereplacement.com/forums/showthread.php?t=27461

Best wishes,

 

[caterb85]

Bob

Bob

Bob

Thanks so much for your time in explaining this. The fact that the doctor told us everything looked good and then to read all this on the report was quite unnerving. If this would be primary PH wouldn't the surgeon have known that before surgery when he did echo. cat scat and heart catherization?

 

[caterb85]

Nancy are you out there some where. I would really appreciate your input. THANKS Cathy

 

[PairoDocs]

Cathy,
Just so you know...
People who are overweight or obese frequently have an elevated ejection fraction and/or mild pulmonary hypertension. The heart does have to work harder, therefore increasing the ejection fraction. This, in turn, can cause the heart to become incapable of relaxing completely, causing diastolic dysfunction, which causes pulmonary hypertension since the blood backs up a little bit. That's part of the reason why overweight folks can get swelling in their feet. It's a pretty consistent finding, almost considered "normal" by some cardiologists.
Similar problems can occur in folks with hypertension or even asthma, as well as other respiratory diseases such as emphysema. And, obviously, heart disease.

While the numbers are important, cardiologists have to take the whole person into account. They also look for changes, which can signify more than the actual number. For instance a sudden drop from an EF of 65 to 55 could mean simply weight loss and better control of blood pressure, or something more ominous.

And, as someone else mentioned, echocardiograms are not always the best way to measure pulmonary pressures and EF. Nuclear scans and cardiac catheterizations are more reliable, not to mention a TEE.

If there are any questions, don't hesitate to ask your cardiologist. Write your questions down and bring in the list.

Warm night in Idaho,
-Laura

 

[abbanabba]

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.

In a healthy heart, each beat should pump out at least 50 percent of the blood in the left ventricle. Therefore, your EF should be between 50 to 75 percent to indicate the heart is pumping well and able to deliver an adequate supply of blood to the body and brain.

Because the left ventricle is the heart's main pumping chamber, ejection fraction is usually measured only in the left ventricle (LV). A normal LV ejection fraction is 55 to 70 percent.

As you can see, what is "normal" or "average" is not necessarily a set-in-stone number, it's more of a guideline as we are all different and depending on our own physiology will have our own "normal" range.

If your husband's EF is 71% it may be on the higher side of normal, but is still within "normal" parameters - however, if his usual EF has always been 58% then yes, it shows something has changed and should be looked into. The same is probably true for the mild PH. It may only be very slightly over normal and may only require monitoring.

I actually had an echo show mild PH about 10 years ago, but it never came up on any other tests and it obviously never developed into anything more if it WAS an issue. I've also had tests show my EF from anywhere between 48%-36% (depending on the type of test and technical interpretation) but given my heart history, my cardio's also think it's OK - all things considered.

I guess it probably doesn't pay to get too hung up on numbers, but to pay close attention to how your husband actually feels. Which isn't to say you shouldn't be aware of his test results and track changes, but if your hubby feels good and his card thinks things are looking good, then chances are there's nothing to get too concerned about.


A : )