Different EF's from different tests?

[margiehubbell]

Hi Dr. Fett,

I am confused. I thought I was recovered since I had a stress test last year and my EF=64. I was thrilled and told that I could do anything a normal person could, except get pregnant. I was also told I had to stay on my Coreg and Digoxin. So this year I had a follow up echo that showed my EF=40-45%
I was so upset that my heart function had declined. I begged for a another stress test because I struggle with exercise, even though before my ppcm I was very active. The stress test (treadmill) showed my EF=65%
How can these two tests show such different results?

I know my heart is not fully recovered because I still have palpitations and shortness of breath and fatigue, some days are better than others and I am thankful for how well I am doing. This is a strange disease that can be frustrating because there does't seem to be any easy answers.

Thank You,
Margie

[JAMESFETT]

Margie, from what you describe, I believe you are talking about different tests. One test is a resting echo, showing an EF of 45 %. The other is a stress echo, indicating that your heart has the capability of reaching, with exercise, an EF of 64 %. This is what is called "contractile reserve," which is very encouraging that your heart has the ability to work harder when called upon to do so. It would be good to review that with your cardiologist for clarification. My experience in that situation is that unless there is other specific indication, you could do just as well without any digoxin; although continuation of the Coreg would be indicated and essential for best function. Again, something to review with your cardiologist. In any case, your tests indicate that your have a very good function, even if not totally normal; and that your prognosis for a long life is very good. There are also radioactive tests, such as the MUGA, that also give EF results, sometimes referred to as the "gold standard" in EF testing. Not absolutely essential however. Best wishes,

JD