Tests for underlying cause of HF

[Badger15]

Need some clarity regarding the HF tests. My son had an echo in July to confirm HF with EF of <35. The cardiac MRI (no stress test carried out) did not reveal any vascular issues. A CT scan has now been requested to investigate further. Can anyone confirm 1) which test confirms EF and how often should that be done? and 2) which is the best test/s to reveal underlying cause of HF? The diagnosis so far is cardiomyopathy due to “viral infection” as no hereditary conditions in family.

[Hidden]

Hi, I trust the following helps, based on my experiences;

Both an Echo and MRI (Rest Test) can confirm EF%, the MRI is considered more accurate, however, the Echo will more than likely be the first test carried out, the result is dependant on many factors, not least the expertise of the Sonographer. That said the result with an MRI could turn out to be very similar. Whilst I have HF, I have an Annual Echo irrespective of EF as it's just one of many factors that they look at with me. I have MRI's few and far between, although my most recent MRI in July showed an increase of 16% compared to an Echo three months earlier. I understand that the MRI Stress Test wouldn't be suitable for me.

I can understand the reasoning behind a CT Scan, prior to my own diagnosis of Heart Failure I had what could best be described as a problematic chest for a few months over the winter of 2021. Eventually, they ruled out a normal chest infection, and were looking at other diagnosis including a viral infection. The CT Scan showed a large amount of fluid in my chest cavity around the heart and lungs. A week later an Echo confirmed that I had Heart Failure.

All the tests that they carry out, help Doctors compile the bigger picture in order that they can provide an accurate diagnosis, but, which is best I couldn't honestly say myself.

As I haven't had a Stress Test, I have no idea if one would be beneficial or not for your son, my forte is with Echo's going back 35 years. As someone who has been in the care of Cardiologists/Surgeons for that amount of time, I trust them impeccably that they are doing the most suitable tests and care for me.

Have trust in what they are doing for your son.

[Badger15 in reply to Hidden]

That’s so helpful and very reassuring- thank you so much!

[Hidden]

I agree with everything Heedio says. Echo and mri to establish Ejection fraction. Echo a little less reliable than an mri but if the sonographer it skilled at reading the reports then they can be nearly similar in accuracy.

[Anon2023]

hi. I’ve had a lot of echos and was told by the cardiac team that they were to give a picture of my heart valve but that a perfusion scan was more accurate for EF. I had a perfusion scan that showed 53% EF and then an echo a couple of months later that showed my EF as 44%. The cardiologist went with the perfusion scan for my EF reading. Apparently there is always a margin of error with scans anyway (+ or -). My heart failure was caused by endocarditis. I was always told that EF is just one measurement of heart health and that other symptoms, or lack of, are equally as important. Good luck.

[Smitty1956]

Hi, Badger 15,

I had a nuclear stress test performed two weeks following my HA in March 2022. That particular test provides the most data concerning heart functioning. My EF as measured at that time was considered “normal” functioning.

Now, 18 months following my HA, I have been having problems with my breathing. I still am having bad times, but I do not see my cardiologist until November to get his interpretation of my echocardiogram.

I had the echocardiogram performed on August 18th. I have read the results, but could use the interpretation. My understanding is that an echocardiogram tells more about the structure of your heart. I was provided an estimated EF, which was still within “normal” limits, but it was much lower than with the nuclear stress test.

I also had a CT Scan in April 2023, but it did not provide info on EF. My EF seems to be normal, but I am still worried that I might have heart failure (HFpEF) because of a couple of other findings.

Someone else may be able to offer more information to you (especially your son’s doctor), but I believe that a specialist could use an echocardiogram or MRI scan or even a nuclear stress test to help in diagnosing HF. Probably the echo would provide the most information on underlying issues within/around the heart.

I wish your son the best in getting a confirmed diagnosis and in getting a treatment plan in place . ❤️