Stroke Volume

[pearsjon]

it has been suggested that i have a 60% stroke volume. i am completely lost. can anyone translate for me and tell me why this would be of concern?!

thanks

[flop]

Hi - were you told this after having an echocardiogram?

On an echo they can estimate your ejection fraction (this would be given as a percentage) (stroke volume it technically a number of millilitres of blood but I don't know of any way of measuring it directly).

Ejection fraction estimates the volume of blood in the left ventricle when the heart is in diastole (when the ventricle has relaxed and is full of blood). The volume of blood in systole (when the left ventricle has contracted to push out the blood) is also estimated. These volumes are compared to see how much of the blood was pushed out when the heart contracted.

I think that this is the value that you have been given.

It is not like being at school - 100% ejection fraction is not a good reading (I suspect that it would be impossible for the heart to completely empty unless there was something odd wrong with it). An ejection fraction of 60% is a healthy / normal value and shows that the heart is pumping effectively.

An ejection fraction of 40% or less usually would fit with some degree of heart failure but it takes more information than just that to make a diagnosis.

I would ask whoever ordered the test to explain the results to you but I think that they are meaning ejection fraction and would therefore be reassuring.

Flop

PS - stroke volume is the volume of blood that is pushed out of the left ventricle when the heart beats. The stroke volume and the heart rate together determine the cardiac output (how much blood is pumped arround your body in a period of time).

stroke volume x heart rate = cardiac output

[mvdula]

flop - you sound like you know more than most doctors!!! seems like some of us here ought to have honorary medical degrees!

[pearsjon]

flop, he said (ans) doc that if i took away your pressures you would be at close to a 60% stroke volume. and went on to say that my 60% and some other normal persons 60% were different. like on a 20 oz drink my 60% is totally different than normal persons 60%. i could be wrong about the whole thing, you talk math and my brain shuts down.

i think he said it cuz i mentioned my diastolic pressure was high when i was awaken from sleep with charlie horse. i have a more signifgcant change in diastolic than systolic. and hr is through the roof. he made it sound like a bad thing. he also said that he can't believe that i haven't just fell out. and if i keep it up (no med thing) i would end up just falling out. if you like i can send you the last month of bp's.

i am not having any luck with rx's and maybe he was trying to convince me to try another one, which i did and now am very sick. so no more meds 4 me. this may not make sense but my bp and hr where ok yesterday and i was sick as a dog. could it be possible that my body is more comfortable out of the norm than in the norm. since i have been out of the norm for awhile? sounds crazy, but i do better with only xanax and a high hr. get me in the normal range and i am ready to go to er.

i have always been like that. whatever something is supposed to do my body has the opposite reaction. such as a crisis. i have always done better under stress than most. which should not be the case with dys right? but the more stress in my life the better i function. maybe i am an adrenaline junkie and just never put the 2 togeher.

sorry just realized i was typing out loud. thanks for reading and responding.

[pearsjon]

flop if i did that formula u suggested my co would be 8.4. i have history of heart probs in my family and have never had a complete cardio work up. they have slways assumed that my low bp waas a definitive sign that nothing could be wrong w/me and i was one of the lucky ones in the fact that i would have a very long life. it bothers me that it has never been a thought to anyone.

grandfather had angina and probably dys (he passed in '87), my father has had 3 heart attacks and one when he was younger than i.(37)

father has had to have electrical system (in body) rewired. can or does ttt or pots rule the others out?

stuppid question from stupid women. but nether less i AM concerned.

doc says its just pots, but i am also listed as ncs and oi, an am assuming once again that this is why they call me dysautonomic.

[flop]

Hi,

There is no such thing as a stupid question - if you don't know or it doesn't make sense then please ask, hopefully one of us will have an answer that makes sense (I often feel my replies are more confusing than helpful!).

You can't actually put "60%" into that formula. Stroke volume has to be measured as a volume (usually in mls) it can't be a fraction (a fraction of what?, as stroke volume is a variable, it will change from beat to beat).

The formula would be:

Heart rate x Stroke volume = Cardiac output

E.g. if Pulse = 60, Stroke volume = 30mls, then cardiac output would be 1.8 L/min

60/min x 30mls = 1800 mls/min

= 1.8 L/min

(those numbers are totally made up, I don't know what a "normal" stroke volume or cadiac output would be).

The only place that I have seen a percentage being used is in "ejection fraction" as I said before. In that case if the left ventricle held 50mls of blood when it was full and 20mls when it had contracted then 30mls of blood would have been pushed out of the heart. 30mls out of 50mls = 60% (the fraction of the left ventricular volume that is ejected from the heart).

The POTS, NCS and OI all go together under the umbrella term of "Dysautonomia".

POTS = the rise in heart rate on standing.

NCS = blackouts caused by faulty autonomic control

OI = symptoms when standing such that you want to sit down.

People with POTS who have symptoms on standing also could be described as having OI. People with POTS who have blackouts would fit the diagnosis of NCS too. The three are part and parcel of the same condition.

A TTT can diagnose NCS and POTS but it doesn't test the heart whilst exercising so it can't rule out ischaemic heart disease (like angina or heart attack). You mentioned that your Dad was "rewired" - do you mean he had a cardiac pacemaker fitted? Pacemakers are used if the heart is beating too slowly to tell the heart to beat faster, sometimes after a heart attack the heart's own pacemaker is damaged so the cardiologists fit an artificial one.

If you are really worried about heart disease then you could ask your doctor about having an echo and a stress test (treadmill) done. However you are a young female both of which make it unlikely that you have significant coronary artery disease (out female hormones protect us until after the menopause). It would probably be more important to make sure your BP isn't high (ha ha - not likely to be a problem for you!), that your weight is normal for your height, that you eat a healthy diet, that your cholesterol levels aren't too high, that you don't smoke, and that you get checked for diabetes every couple of years (simple urine dipstick to look for sugar in the urine). If you manage to keep all of those on track as well as living with POTS then you will be a very determind young lady who has done everything possible to look after her heart and minimize the chances of having a heart attack when you are older.

sorry to put so much technical stuff in one thread, I hope it makes sense and that you can talk things over with your doc to put your mind at rest.

Flop

[pearsjon]

thanks flop,

i don't think it was a pacemaker for my dad. i'm lucky i got anything out of him at all. med probs r like secretive in my family. i have no idea why. he said that his heart would pound so hard that it would lift him off the bed. and they rewired it. that is all i know. i have my ovaries but have had hysterectomy, so i worry about the early menopause. my cholesterol is high, and LDL is low, but they won't do anything with it cuz i have so many muscular probs they can't dx. cramping and pain, tenderness and such.

i get what your saying and thanks again for taking the time. i am not going to worry about it. i was only concerned cuz my diastolic tends to be over 85 most of the time and showing irregular heartbeats. and my muscles start to ache.