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Left ventricular ejection fraction (LVEF) less than or equal to 35% (HF)

CPT4 code

Name of the Procedure:

Left Ventricular Ejection Fraction Measurement (LVEF ≤ 35%)
Common name(s): LVEF Test
Medical terms: Echocardiography, Radionuclide Ventriculography, MRI

Summary

Left Ventricular Ejection Fraction (LVEF) measurement determines how well your heart's left ventricle pumps blood. It is a vital diagnostic tool for heart failure (HF) patients, particularly when the LVEF is 35% or lower, indicating severe heart dysfunction. This test typically involves non-invasive imaging techniques.

Purpose

The LVEF test assesses heart function to diagnose and monitor heart failure (HF).
Goals:

  • Evaluate the heart’s pumping efficiency.
  • Determine the severity of heart failure.
  • Guide treatment decisions.

Indications

  • Symptoms of heart failure (e.g., shortness of breath, fatigue).
  • History of heart attack.
  • Cardiomyopathy (disease of the heart muscle).
  • Monitoring the effectiveness of heart failure treatment.

Preparation

  • Fasting may be required for certain tests.
  • Medication adjustments might be necessary (consult your doctor).
  • Baseline diagnostic tests, such as blood work, an ECG (electrocardiogram), or previous echocardiograms may be reviewed.

Procedure Description

  1. Echocardiography: The most common method, using ultrasound waves to create images of the heart.
  2. Radionuclide Ventriculography: Uses radioactive materials to image how blood fills the heart chambers.
  3. Cardiac MRI: Provides a highly detailed image of heart structures.
    • The patient lies on a table while an imaging device scans the heart.
    • Usually non-invasive and painless.
    • Sedation or anesthesia is generally not required.

Duration

Typically takes 20–45 minutes.

Setting

Performed in a hospital, outpatient clinic, or specialized cardiology center.

Personnel

  • Cardiologist
  • Radiology technician or sonographer
  • Nurse (depending on the setting)

Risks and Complications

  • Echocardiography: Minimal to no risk, very safe.
  • Radionuclide Ventriculography: Slight exposure to radiation.
  • Cardiac MRI: Rare allergic reaction to contrast dye, if used.

Benefits

  • Accurate assessment of heart function.
  • Helps tailor individualized treatment plans.
  • Early intervention and management of heart failure.

Recovery

  • No significant recovery time for echocardiography and radionuclide ventriculography.
  • Rest for a short period after cardiac MRI, especially if contrast dye is used.
  • Follow-up appointments may be scheduled to discuss results and treatment plans.

Alternatives

  • Continuous heart failure management with medication and lifestyle changes.
  • Invasive procedures like cardiac catheterization.
  • Pros: Non-invasive options like echocardiography are safer and more comfortable.
  • Cons: Invasive procedures may provide more detailed information but come with greater risks.

Patient Experience

  • Generally painless and non-invasive.
  • May feel discomfort from lying still or slight anxiety from imaging machines.
  • Pain management not typically needed.
  • Comfort measures include a calm environment and reassurance from medical staff.

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