Search our website Find job opportunies at THI and St. Luke's Find a doctor location and contact information
Heart Information Center
 
Ask a Heart Doctor
  Back to previous page

 

Help us improve this service.

Your feedback will help guide us in developing this site.

Ask a Texas Heart Institute Doctor 
Informed patients make better patients.

Question:

Is it possible to have a 'clean' heart cath and normal EF, and still have CHF? 

Is it possible to have a "clean" heart cath, normal EF and still have CHF? I can gain sometimes 6 pounds of fluid in 48 hours, kidney function is normal and I recently had a cardiac work-up with the above results.

submitted by David from Lynch, Kentucky on 7/11/2013

Answer:

by Texas Heart Institute cardiologist, Domingo Gonzalez, MD  

Domingo G. Gonzalez, Jr., MD The answer is yes, one can have CHF [congestive heart failure] and have a "clean" heart cath with a normal left ventricular ejection fraction. The term clean is not based on science but typically means that the coronary arteries have no or minimal angiographically detectable atherosclerosis. A typical left heart cath with left ventricular angiogram should address the angiographic status of the coronary arteries, the left ventricular ejection fraction, whether there is significant mitral valve regurgitation (leakage / insufficiency) and whether there is significant aortic valve stenosis (narrowing).  

A heart cath does not typically address the following potential causes of CHF:
Aortic valve insufficiency 
Mitral valve stenosis 
Pulmonic valve stenosis or insufficiency 
Diastolic left ventricular dysfunction 
Right ventricular failure 
Pulmonary artery hypertension 
Constrictive heart disease 
Restrictive heart disease 
Pericardial fluid collection

All of the above can cause CHF and fluid retention. To investigate these, a more extensive heart cath and possibly other types of tests would be in order. There would have to be a clinical level of suspicion to direct the more extensive evaluation.

Additionally, other causes of edema or fluid retention not associated with CHF can be the culprit, such as thyroid or liver disease. 

See also on this site:       

Has your question or a similar one already been answered?
Search all the Heart Doctor questions and answers.

To search for a doctor or access St. Luke's physician referral service, use the "Find a Doctor" link at the top of this page.


Updated July 2013
Top  
Like us on Facebook Follow us on Twitter Subscribe to us on YouTube Find Us on Flicikr Follow Us on Pinterest Add us on Google+ Find us on LinkedIn

Please contact our Webmaster with questions or comments.
Terms of Use and Privacy Policy
© Copyright 1996-2014 Texas Heart Institute.
All rights reserved.
This website is accredited by Health On the Net Foundation. Click to verify. U.S. NEWS America's Best Hospitals 2013-14