3021F Left ventricular ejection fraction (LVEF) less than 40% or documentation of moderately or severely depressed left ventricular systolic function (CAD, HF)

Name of the Procedure:

Left Ventricular Ejection Fraction (LVEF) Measurement

Summary

The Left Ventricular Ejection Fraction (LVEF) measurement is a test used to assess the percentage of blood the left ventricle pumps out with each contraction. This measurement is crucial for diagnosing and managing heart conditions such as coronary artery disease (CAD) and heart failure (HF).

Purpose

The primary purpose of measuring LVEF is to evaluate the heart's pumping efficiency. This procedure helps in diagnosing heart conditions, monitoring their progression, and guiding treatment decisions. A low LVEF (less than 40%) indicates compromised heart function, critical for managing CAD and HF.

Indications

• Symptoms of heart failure: shortness of breath, swelling in legs, fatigue
• History of heart attack or coronary artery disease
• Diagnosed heart failure or cardiomyopathy
• Pre/post-operative assessment for certain heart surgeries

Preparation

• No fasting usually required unless specified by the healthcare provider
• Patients may need to adjust or withhold certain medications as advised
• Diagnostic tests such as an echocardiogram, MRI, or nuclear stress test may be conducted beforehand

Procedure Description

1. Echocardiogram Method:

   • Patient lies on an examination table.
   • A technician applies gel to the chest area and uses a transducer to capture heart images via sound waves.
   • The transducer sends images to a monitor, which a cardiologist will analyze.
2. MRI Method:
   • Patient lies on a bed that slides into an MRI scanner.
   • Detailed images of heart structures and blood flow are captured through magnetic fields.
3. Nuclear Stress Test (if used):
   • A small amount of radioactive material is injected into the bloodstream.
   • A special camera detects the material as it flows through the heart during rest and exercise.

• Anesthesia: Generally, local anesthesia or sedation is not required for an echocardiogram, MRI, or nuclear stress test.

Duration

• Echocardiogram: Typically 30-60 minutes
• MRI: Approximately 90 minutes
• Nuclear Stress Test: 2-3 hours in total

Setting

• Hospital or outpatient clinic

Personnel

• Cardiologist
• Radiology technician (for MRI)
• Sonographer (for echocardiogram)
• Nuclear medicine specialist (for nuclear stress test)

Risks and Complications

• Echocardiogram: Very low risk
• MRI: Claustrophobia, rare allergic reactions to contrast material
• Nuclear Stress Test: Allergic reactions to radioactive material, very rare

Benefits

• Accurate assessment of heart function and immediate feedback
• Critical for diagnosing and tailoring treatment plans for CAD and HF
• Helps in monitoring disease progression and effectiveness of treatments

Recovery

• Most patients can resume normal activities immediately post-procedure
• If contrast agents are used, patients may be advised to drink plenty of fluids to flush it out
• Follow-up appointments to discuss results and treatment plans

Alternatives

• CT Angiography: Non-invasive, uses detailed CT imaging but involves radiation
• Cardiac Catheterization: More invasive, direct measurement but higher risk
• Blood Tests: Indicative but not definitive for LVEF assessment

Patient Experience

• Generally painless for echocardiogram and MRI
• Some discomfort from lying still or having a transducer pressed against chest
• Possible mild side effects from radioactive material used in nuclear stress test
• Minimal recovery time with normal activities resumed quickly