Ejection Fraction - Echo or MRI Cardio

[Moldova1234]

Hello All

I wonder if somebody here can help me to clarify an issue I have with my Echocardiogram & MRI Cardio/Cardiac tests I have had done to determine my ‘Ejection Fraction’?

A few years ago in 2018 I had an Echocardiogram which showed I had an Ejection Fraction of 43% and left ventricular dysfunction & around the same period I had an operation to reduce an enlarged prostate & the next day was hospitalised with Ventricular Tachycardia ( VT) with a heartbeat of 110 bpm.

At hospital my heartbeat returned to normal without any treatment but I was kept in for 5 days for observation & tests and eventually released with a prescription of Bisoporol.

After 6 months on Bisoporol I suddenly developed VT again one day and was blue lighted back to hospital with a heartbeat of 200 & had to receive an electric shock under anaesthetic to return to normal.

I was given another prescription ( I forget the name as the Bisoporol was having a debilitating effect on me making me very tired & dizzy etc) & was discharged only to be blue lighted back again a week later with a heartbeat of 210.

This time I received a ‘Cathater Ablation’ which I was told was a success by the consultant & given a prescription of Ramipril before being discharged.

About 4 months later I was given another Echocardiogram which showed an improvement in my ejection Fraction of 49% & about 2 months after that was given an MRI Cardio/Cardiac which showed I had an ejection Fraction of 56% which the consultant informed me was normal & wrote that on my report.

About 4 months later I had a follow up Echo which showed 49% again & a follow up MRI Cardio/Cardiac which showed 56% again.

I was told by the consultant that the MRI is the the gold standard & more accurate test for ejection Fraction & that I should be reassured that it is now normal.

14 months after my Cathetar ablation I have not had any more VT attacks my heartbeat has been steady around 50-60 bpm mark & I have been taking atorvastatin which has kept my total cholesterol down below 5 & Ramipril 1.25 mg per day which keeps my blood pressure around 130/80.

I go jogging 2 or 3 times a week & do the 5k Parkrun in in my area every Saturday morning although at a very slow pace! And overall I’m doing ok at the moment.

My dilemma/query is should I accept the MRI result of a 56% Ejection Fraction which I’ve been told is normal or the Echo figure of 49% Ejection Fraction which shows I have mild systolic dysfunction?

My local doctor’s surgery keep mixing up my notes with one doctor pulling up my initial Echo result of 43%, another pulling up my subsequent Echo result of 49% & another telling me your Ejection Fraction is normal at 56% with the MRI! So now I am confused as to which ejection Fraction figure I should accept? And is my EF now normal?

[Prada47]

Hi Moldova

I would take the MRI as the accurate EF

The Echo is more than a guess, but it can be as much as + or - 3 to 5 % out which can be under recording, or over recording. That is what I have been told, but I know my Cardiologist is a fan of the MRI result rather than the Echocardiogram .

I was once asked by a Supervising Technician during an Echocardiogram did I know my EF because they couldn't quite decide. I said it was some times between 40 and 45 % Amazingly the result was 43% lol

Don't forget no one on here is medically trained just repeating what we pick up on our journey through this maze of Heart Problems.

Stay Well

Stay Safe

I forgot to mention do you have any Symptoms which suggests you have a lowered Ejection Fraction ??

[sherwood123]

With my Ejection fraction down to 15-20% I would accept either reading, sounds like you doing fine fitness wise. After double bypass and a Crtd-d device fitted recently , I am hoping to it will rise, and if it gets to 40, it would be wonderful. I have been told the numbers are approx and all depends how you are feeling! Regards

[Moldova1234 in reply to sherwood123]

Hi Sherwood123

When I initially heard that my EF on the first Echo I had was 43% I read all I could about EF on the internet ( reading mainly academic & medical articles by doctors & consultants) & they all seemed to agree that EF can be improved & a better quality of life attained by simple lifestyle changes ie losing weight ( if overweight), eating a well balanced diet, with chicken & fish, fruit & vegetables & less red meat, leaving out coffee & electing for herbal teas & plenty of bottled water, a regular exercise routine ( only to be commenced on the advice of your doctor) ,getting a regular good night’s sleep & making sure to take any medication prescribed regularly by your doctor ( I have been taking Atorvastatin for my cholesterol which was marginally high but now below 5 total & Ramipril ). I embarked on all this & the next time I took an echo my EF had increased to 49% an increase of 6%! so hopefully you can improve your EF too! However make sure to schedule an appointment with your doctor prior to embarking on any recovery programme to ensure it’s done in a safe manner. I was feeling tired & lethargic & sometimes a little dizzy when I was first referred by my doctor to take an Echocardiogram & I can honestly say I have felt a lot better since I decided to be proactive about my initial low EF & try to improve my condition & I feel that you can improve EF if you go about it in a controlled, steady & informed manner guided by the doctors & consultants. I sincerely hope you can make some progress with improving your EF Sherwood! Good luck & best of wishes in this direction!

[sherwood123 in reply to Moldova1234]

Thanks for your reply, unfortunately I am one of those who ticks all the right boxes , right weight , proper diet, bike riding, strong and fit, blood pressure perfect, and no other underlying problems. But last September felt a unwell, test after test I have been diagnosed with severe heart disease. All my family and friends cannot not believe it, but it is what it is, so trying to get back to something like pre problems.its early days I am very fortunate to be still alive to get back to a near normal life, my father died at 64 with a massive heart attack, my belief is it is hereditary, and regardless of my fitness and health is was properly going to happen.i did have heart scan years ago after he died but everything was ok.regards

[MichaelJH Heart Star]

A Echocardiogram calculation is a 2D estimate only accurate to the nearest 5%. Quoting a figure that does not end in 0 or 5is fairly irrelevant. The MRI is 3D, more accurate and the one to use.

However, more important generally than the EF are the symptoms as these are what affect your quality of life.

[beardy_chris]

As I understand it (and I'm not a medic), the Echo gives essentially a 2D picture of the heart from which they infer a 3D model to calculate ejection fraction. The MRI gives a 3D view so they can more accurately determine what is going on.

[Pete1]

If you feel fine then I would guess your EF is within your own normal parameters.