Lately, I have been thinking a lot about Aohdan's next cardiology appointment. It is still a month away! Aohdan's cardiologist does not really like using numbers to determine how well Aohdan is doing. I understand that numbers cannot give us the full picture and are not always accurate but it is at least something that helps me to grasp whether there is improvement or not. The numbers that are used by cardiologists to measure the health of a heart are the ejection fraction and shortening fraction. I thought I would go into a little more detail about these two measurements in today's post.
Ejection Fraction: is the measurement of the amount of blood leaving your heart each time it contracts.
If you watched the video from yesterday you will have noticed that the when the ventricles contracts blood leaves the chambers and when they relax they refill with blood. However, no matter how strong the contraction is it never empties completely. So, the term 'ejection fraction' refers to the percentage of blood that's pumped out of a filled ventricle with each heart beat. The left ventricle is considered the "heart's main pumping chamber" and it is the one that doctors use to measure the ejection fraction. A normal left ventricle ejection faction is 55-70%. Aohdan's is 37%.
Ejection fraction can be measured through various techniques with the echocardiogram being the most common. The echocardiogram sound waves are used to create images of the heart and the blood pumping through the heart.
Another way it can be measured is through magnetic resonance imaging (MRI). I have been hearing about this technique a lot recently on the CCF forum. I guess it is becoming more readily used in working with cardiomyopathy patients. I will go into this a little more after discussing shortening fraction.
Shortening Fraction: measures and ratios the change in diameter between the relaxed state and constricted state of the left ventricle. The normal range is 18-42%. I am not sure what Aohdan's shortening fraction is but I do know that it has been measured. I plan to ask the cardiologist at the next appointment.
Shortening fraction also can be measured using various techniques as well with the Holter Test being the most common. This is a monitor that detects the electrical activity of the heart. To detect abnormal heart rhythms, it is worn for 24 hours, providing a recording for the doctor. Non-typical heart rhythms can be a symptom of left ventricle problems.
Cardiac MRI: A cardiac MRI is typically used when a echocardiogram is inconclusive or inadequate. An MRI is more accurate and can help determine the size of the heart more clearly, it can detect where there is damage to the heart and what can be saved, it can even help to detect cause in some cases. However, because an echocardiogram is more available, fast, and you can have one even if you have some implanted metal on you like a pacemaker it is often the method used.
I have to admit this sounds a little bit appealing to me. I like the idea of accurate results. However, I am not sure if it would be worth it or not. For one, Aohdan would most likely have to be put to sleep to participate because the patient has to lay perfectly still. I don't know about you, but I don't know how to keep a baby still for very long, even a sleeping one!
Heart Beat Moment: Aohdan was laughing so hard today. I got a short video of it.