Your heart is a muscle that pumps blood through your body, so you obviously want to keep it healthy and working at its full capacity. Ejection fraction (EF) is a measurement that your physician may use to gauge how healthy your heart is. Your ejection fraction is the amount of blood that your heart pumps each time it beats.
Ejection fraction is measured as a percentage of the total amount of blood in your heart that is pumped out with each heartbeat. A normal ejection fraction is 50 percent or higher. An ejection fraction below 40 percent means your heart isn’t pumping enough blood and may be failing.
A low ejection fraction number can be an indicator of heart failure and may not have symptoms at first but can lead to a variety of symptoms, including:
- Shortness of breath
- Fatigue
- Irregular heartbeat
- Abdominal discomfort
- Swelling in the legs and feet
What is ejection fraction?
A healthy heart contracts (empties blood) and relaxes (refills blood) 60-80 times each minute. With each heartbeat, the heart pumps blood from the left and right ventricle.
In most cases, ejection fraction refers to the percentage of blood that's pumped out of the left ventricle with each heartbeat. For example, an ejection fraction of 50% means that 50% of the blood from the left ventricle is being pumped out during each beat.
There are two types of ejection fraction: left ventricular and right ventricular. Left ventricular measures how much blood gets pumped from the left ventricle with each contraction. Typically, ejection fraction refers to left ventricular. Right ventricular ejection fraction measures how much blood is pumped out of the right side of the heart, to the lungs.
What are the tests used to measure ejection fraction?
There are several reasons why your doctor might want to test your ejection fraction. For example, if you have symptoms like fatigue or shortness of breath, your doctor may want to see if your heart is failing. Your doctor also may want to test your ejection fraction if you have a history of heart disease, high blood pressure or diabetes. Testing your ejection fraction can help your doctor figure out if you have heart failure and how severe it is. It also can help guide treatment decisions.
Your doctor may order tests to determine your ejection fraction including:
- Echocardiography – the most common test used to measure ejection fraction.
- Cardiac catheterization
- MRI (magnetic resonance imaging)
- Nuclear medicine scan
- CT (computerized tomography)
What do ejection fraction numbers mean?
- 55 to 70% – Normal heart function.
- 40 to 55% – Below normal heart function. Can indicate previous heart damage from heart attack or cardiomyopathy.
- Higher than 75% – Can indicate a heart condition like hypertrophic cardiomyopathy, a common cause of sudden cardiac arrest.
- Less than 40% – May confirm the diagnosis of heart failure.
How can you improve your ejection fraction?
There are several things you can do to improve your ejection fraction if it’s low. First, you need to manage any underlying conditions that may be contributing to your low ejection fraction, such as high blood pressure, diabetes or coronary artery disease. You also need to make lifestyle changes, such as exercising regularly, eating a healthy diet, and quitting smoking. In some cases, you may need medication or surgery to treat heart failure.
Some other steps you can take to improve your injection fraction include:
- Limiting salt – the average American eats nearly 3,400mg of sodium a day – more than double the recommended amount.
- Watch your fluid intake – talk with your cardiologist about how much fluid to consume each day.
- Exercise – try some type of physical activity 30 minutes each day, three days a week.
After the initial ejection fraction measurement, your doctor will check the number as needed, depending on your condition. Because ejection fraction is just one measure of how well the heart is working, even when this number is normal, the heart may not be functioning properly.
Heart failure is a complex disease, but it is manageable – especially when you are armed with the right information.
Our heart failure team is "certified and advanced" by the Joint Commission, meaning we specialize in treating patients with heart failure and take the time to answer all of their questions.