7/30/20: Echocardiogram Results

At today's physical therapy appointment, my therapist asked how my latest echocardiogram looked. I realized I had forgotten to look for my results online, and now I wish I had known the results at the appointment, so I could have asked my therapist what they mean.

I got the echocardiogram report from the online patient portal. My ejection fraction is now 53%. The report says a number between 54% and 73% is normal. 

I made a post asking for information in a couple of the Facebook support groups. Most everyone said 50% was the cut-off for the normal range, which is also what I found online. Several women said that when their ejection fraction got too low (in some cases as soon as they hit 50%, but one woman went as low as 41%), they were referred to a cardiologist, who prescribed medication. Some had to take a break from Herceptin until their ejection fraction improved. Others were able to continue Herceptin treatment while taking the medication. It sounds like the ejection fraction can eventually return to normal, though it might take a few months or a year, and then the medication can be stopped. 

One person said that the 50% number wasn't as important as the change from baseline, and that a difference of 10% was the threshold for concern. By that measure, I'm right at the borderline, since my first echocardiogram had an ejection fraction of 63%. Another person said her medical oncologist said a difference of up to 15% was tolerable.

The idea of stopping treatment is discouraging because I'd like to know that I've done everything I can to reduce my chances of recurrence. Interestingly, someone pointed me to a recent study that showed that 6 months of Herceptin is pretty much just as effective as 1 year of Herceptin. It's definitely reassuring. I've already had 10 months of treatment, so I think I won't feel too bad if I have to stop early.

A couple people suggested that addressing a low ejection fraction would be more urgent if I was symptomatic. It hadn't even occcured to me that I might have related symptoms. I found a list of symptoms online, and I don't think I have any of them, except maybe possible swelling in my feet, but that could also be from hormone therapy.

I want to discuss my echocardiogram results with my medical oncologist, to see if my ejection fraction will affect my Herceptin treatment, but my next appointment isn't until my last scheduled infusion! I have a Lupron appointment next week, though, so I'll ask my nurse about it. Part of me figures, if there's anything to worry about, surely my oncologist, or the NP, would give me a call.