Saturday, February 02, 2019

Fractional Shortening


That title has nothing to do with my cooking skills, alright? One thing I often kept on the fringes of my situational awareness, was the possibility and influence of silent ischemia, under physiological stress. Often, this is a sequelae of low ejection fraction; commonly, one begets the other. Anyway,
I do know, that this concept was not a part of everyone's patient assessment skills.

Your Ejection Fraction
Can rule the day,
Do let me explain
It's worth it, I say.

What is the E.F?
It has to do with your heart,
How much blood gets squeezed out
The contractional part,
At the maximum push
On the arterial side,
The Left Ventricle, I mean
How much blood takes a ride.

This cardiac output
How much ejects, every time,
Doesn't empty that chamber
A paradox crime,
Where one might assume
A full on ejection,
But that isn't the case
'Tis a means of protection.

I could describe
A hundred different factors,
With 99 arguments
And other detractors,
Opinions and guesses
Expertise and understanding,
Massive strata of data
Some weak, some commanding.

Still, we measure indices
We compare and predict,
EF influences outcomes
How the heart doth constrict,
The workload, the demand
Regarding MVO2,
Myocardial oxygenation
Just between me and you.

50 to 70 percent
Is the rule,
The range considered normal
As a comparison tool,
The lower it drifts
We wonder what disease,
Caused damage to the heart
Let’s discover it, please.

The lesser the measure
The greater the risk,
Cardiac performance
No longer is brisk,
A threat of sudden death
With a failing pump,
Silent ischemia
A Troponin bump.

Keep a wary eye
When low EF is known,
If you detect subtle changes
Get on the phone,
Have a word with the Doctor
Share your concerns,
Save a life today
And everyone learns.






1 comment:

Oldfoolrn said...

Listening to TV, a rare occurrence for me, I heard the CEO of IBM describing how medically smart her Watson computer was. She referred to ejection fraction as ejection FRACTURE. Not so smart after all.