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Ejection fraction query - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Hypertension and Heart Disease
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2305 Questions
After 5 stress test over 10 years my Ejection Fraction has been calculated and estimated from 47 to 50, except for the last one which was 55%.The cardiologist progress notes say he calculates it at 50, no significant change. My weight,diet and exercise are all good.Should I expect my EF to remain unchanged? I'm a 64 yr old male.
Doctor :   Hi
Doctor :   yes
Doctor :   your EF is good and has been stable
Doctor :   Over time as you age the EF may reduce
Doctor :   But if you keep fit and work out, the heart will keep pumping and the EF will be good
Doctor :   Are u there ?
User :   Notwithstanding above question, the Vet Admin is sending me to a contract Dr. The cut off is an EF of 50 for a 60% disability. How can I avoid a subjective 5% addition to the ef?
Doctor :   what does the echo mention as the EF ?
Doctor :   Are u there ?
User :   My last ecg may 2010. Im looking at it no ef %. But it reads 58 bpm sinus bradycardia.
Doctor :   EF is mentioned in the echjocardiogram
Doctor :   not in the EKG
User :   I don,t know. But I have med records back to 1999 when I had stent placed. Why do you ask?
Doctor :   so the last echo and the EF you know is 50 % , right ?>
Doctor :   To be eligible and recieve the 60 % disability , you can speak to the concerned doctor and he may do the needful for you
User :   negative.I do not know last echo. But the last stress test was an ef 0f 55%, but the cardiologist said no significant change and satated a calulation of 50%. I think this baffaled the VA. slow typer. sorry.
Doctor :   In that case, you need to ask for clarification and then if needed get an echo done again
Doctor :   this may remove all confusion and give you the neeful
Doctor :   needful **
User :   should the echo be the same or close?
Doctor :   it should be 50 %
User :   what is needful
Doctor :   once you get the echo, done and it shows that the EF is 50% , this will give you the needed cut of to claim the disability
Doctor :   the stress test % is different, it means that you achieved 55% of the top level that you needed to reach
Doctor :   the Ejection fraction is determined by an echocardiogram
Doctor :   the normal value should be above 55 to 60%
User :   I need to assume they will only consider my dr exam on friday and the possibility of a stress test. Their regulations (va) onlt speak of stress test ef.
Doctor :   ok
Doctor :   in that case, it will not change much
Doctor :   it will change only if your ability to walk or excercise has changed
Doctor :   you should be able to get to 50%
User :   does the stress -my own- possibly elevate the ef? And how about the subjectivity factor?
Doctor :   no
Doctor :   if u r stressed very much , you will not be able to increase the EF
User :   How much subjectivity is involved with interpreting the test results?
Doctor :   the results are based on a calculations of your age , weight to height ratio
Doctor :   the limits of the test is decided first and then you have to reach at least 85 % of the calculated stress levels
Doctor :   I am not sure about the subjectivity
Doctor :   there is no term called subjectivity here
User :   Would three Dr's look at the same test results and come up with the same %?
Doctor :   yes
Doctor :   the percentage will be mentioned in the test result
Doctor :   the doctors do not have to apply any formula or calculate anything
Doctor :   for example, at a age of 50, you need to reach a heart rate of 150, to reach a 100 %
Doctor :   if you reach a HR of 100, then you have reached aound 66%
User :   My condition is what it is and I want good health, but I don't want to miss out on compensation because of different interpretations. Any advise? (I understand your latest)
Doctor :   so the stress levels and the target heart rate you have to achieve is set by the testing system, and based on your perfomance, on the test
Doctor :   i understand, what you mean
Doctor :   in that case, when you go for the test, ask the technitian, what is the target rate u need to achieve
Doctor :   and then try to see the HR you reach, on the machine pulse monitor
Doctor :   and try not to exceed 50% of the target rate
Doctor :   this may give you a EF of 50% that is the cut off
User :   what do you think the target is?
Doctor :   this way you may become eligible for the disability
Doctor :   for you i think, it may be around 180
Doctor :   i mean the heart rate
Doctor :   I hope i have answered your queries
Doctor :   take care and bye for now
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