Can a decreased ejection fraction be concerning?

Question

Hello doctor,

I am a 57-year-old male and the results of my recent annual resting echo showed the following. Tri-leaflet aortic valve with well-compensated moderate regurgitation (2-3/4) as well as mild aortic sclerosis but no stenosis. Normal size left ventricle (130 mL) and no evidence of hypertrophy or remodeling. Low normal systolic function with an ejection fraction of 54 percent. A normal right ventricle size and function, mildly dilated left atrium and mildly dilated aortic root (41 mm) and ascending aorta (41 mm).

In addition, it is noted that my resting ejection fraction last year was 64 percent and my stress echo taken this year (for atypical chest pain) was 62 percent. My cardiologist says all my echo parameters are stable and he does not want to see me for another year. Despite my cardiologist reassuring me that I have nothing to worry about, I remain a little concerned about the drop in my ejection fraction from last year to this year.

Should I be worried about this or is it still in the normal range?

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Firstly, since it is a moderate regurgitation and compensated, it is not expected to damage your heart that badly and drop your ejection fraction. Also, echo is a subjective investigation, and while calculating, a slight change in cursor positions may change the ejection fraction by five to 10 percent. The next thing is, your ventricle size is normal and it should have enlarged if your ejection fraction is really dropping.

So, due to all the above reasons, I think this borderline value of ejection fraction is due to a measurement variation. I do not think it has dropped significantly and there is no need for excessive worries. At this stage of regurgitation, it only needs monitoring. Surgery is considered in case of severe regurgitation, significantly enlarged ventricles along with low ejection fraction. So, no need to worry, and the future plan should be monitored with echoes.

I hope this helps.

Thank you.