Echo Accuracy

I am going for my annual echo on Thrusday. Just wondered how accurate echos arre in general.  Mine as fluxuated between 42 and 28 the last few years and has gone up and down and up again. I just do not want to freak out if it goes down again.




by Selwyn - 2021-03-24 13:22:15

If we are speaking about echocardiograms, then be reassured they give a good view of the structure of the heart ( you can even see the flap valves working), wall movement, and thickness of the heart muscle ( down to the last millimeter. You also get a picture of flow rates.

If by fluctuation, you  are talking about heart rate, then I dare say the beat to beat count is accurate.

I would suggest you discuss your anxieties with your medical team. There should be no need to "freak out" with what is a routine, painless, investigation.  Whatever is going on in the investigation is going on any way!  

Personally, I have always found echocardiograms to be quite interesting and offer you a unique opportunity to view your heart functioning. Sometimes they are technically challenging and things like heart apex movement, the root of the aorta, may be hard to visualise depending on personal anatomy. 

With regard to trans oesophageal echocardiography, this is especially useful for visualising the left atrium ( +/- any clots)  which lies very near to the wall of the oesophagus, and the other heart structures that are more to the back (the aorta, pulmonary artery, valves of the heart, both atria, atrial septum, left atrial appendage, and coronary arteries). 




Accuracy depends on the quality of the images and the skill level of the person interpreting them

by asully - 2021-03-24 13:22:16

I have had similar experiences to you in regards to echos.  The numbers are often a broad estimate so if the say your LVEF is 30 you really could be between 20-40 as there is a margin of error that is quite large.  If you look at some of the other measurements like the size of your ventricles, and atria as compared with previous echos they can be quite accurate.  A regular echocardiogram is not as accurate as a TEE (where they put you to sleep and get the images from your esophagus), if there is every any question as to accuracy I request a TEE.  The image quality is much better so depending on what they are looking for it may not be as clear on a standard echo (if you want an example PM me and I will tell you about my mitral valve expierience).

All in all the best thing is to compare your current echo with previous ones, that way they can track changes overtime.  I always request a copy of all the measurements (and ask the sonography to record as many measurements as they can) that way I can go back and look myself to make sure nothing was missed.  I am a bit OCD about it, however it has saved me once already so it's worth it IMO.

Ditto Selwyn and Asully

by Gemita - 2021-03-24 13:35:08

Providing the technician/operator is skilled and qualified, an echocardiogram procedure is an extremely accurate test of the function and structure of your heart. 

An echo will give your cardiologist lots of information about your heart chambers, their size, whether there is any enlargement, thickening, valve problems, how well your heart is pumping and functioning in general.  Any noticeable fluctuation (deterioration/improvement) in EF is caused by changes in your heart condition not by the machine inaccurately measuring your EF.  

But our EF can fluctuate for a number of different reasons, but the echo will usually pick these up if they relate to valves, heart muscle disease etc.  Depending on body build, some operators may have a difficult time getting good views, thereby echo study may prove inadequate. It did for me on one occasion and had to be repeated.  

I would say depending on the skill of the operator and what your doctor wants measured, an echo is a useful first tool to use, but of course some conditions may need more invasive tests to improve diagnostic accuracy.  For example my husband needed right heart catheterisation for monitoring his pulmonary pressures because of the limitations of the echo study.

Ditto, ditto and ditto

by AgentX86 - 2021-03-24 17:28:38

Echocardiograms are very accurate but the cardiologist interpreting them may not be so.  It would be good if you could always get the same person doing the analysis so the numbers would be more consistent, if not accurate.  If yours are all over the place, I'd be concerned that the cardiologists reading the echos weren't all that competent and the data is pretty useless.  The idea is to see, not only numbers, but trends.

As  noted TEEs are even better for some things but they're a lot more difficult because the probe has to go down the esophagus, which isn't fun.  I've done it a few of times, looking for LA clots before an ablation. It's certainly not my idea of a nice day in the park.  The last time, I finally gave in and decided that "I'm going to get this crap over, now" and down it went.

Edit: I wrote "cardioversion" but it was before ablations.  There wouldn't be a point in doing it while consious for a DCCV because they're going to put one out anyway.

Ditto infinity...

by asully - 2021-03-24 18:04:13

Everyone has nailed all the aspects lmao.  I did want to add that what Gemita said about right heart catheterization is also true.  Sometimes they need more data.  They can also do a cardiac MRI provided your pacemaker is MRI safe and your leads are capped and you don't have any other surgical pins that could be disrupted by the magnet.  I can't get the cardiac MRI so they use everything else, right heart cath, x-ray, echo, trans esophageal echo, cpet (exercise testing), bloodwork, etc etc.  I also want to add that I know how stressful and discouraging it can be when you get a bad LVEF from an echo (I just recently had that expierience), after an hour of tears and some cuddles from my fiancé I realized that reacting emotionally wouldn't change my situation,  I still get bummed out and frustrated from time to time but usually it is short lived now.  If you do get an unexpected result that is stressful feel free to reach out, many of us have been through very similar expieriences.

Cardiologist only

by Tulp - 2021-03-24 23:02:05

In my French hospital, the ultrasounds are only performed by cardiologists.

They said to me the accuracy is around 5 % concerning the EF.

I hope you will have good news. Fingers crossed

Echo Results

by lefty2 - 2021-03-30 17:20:26

I did receive a 7 page report on the echo results. It stated that my EF was 30-35. I was trying to find the actial number on the report. Under "Measurements", it stated : LV Ejection Fraction 4C a 36.9%. Is this my EF or is it a calculation based on other numbers. 



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