Your heart’s Ejection Fraction is a number, expressed as a percentage, showing the amount of blood that is being pumped out of your heart’s ventricles with each contraction, in relation to how much was in it, to begin with.
Your heart’s ejection fraction may decrease if:
➡ You have weakness of your heart muscle, such as dilated cardiomyopathy, which can be caused by a heart muscle problem, familial (genetic) cardiomyopathy, or systemic illnesses
➡ A heart attack has damaged your heart
➡ You have problems with your heart’s valves
➡ You have had long-standing, uncontrolled high blood pressure
Left Ventricular Ejection Fraction (LVEF) refers to how well your left ventricle pumps blood with each heartbeat.
Right Ventricular Ejection Fraction (RVEF) is the measurement of how much blood is being pumped out of the right side of the heart to the lungs for oxygen.
However, since the left ventricle is the heart’s main pumping chamber, most of the time “Ejection Fraction” refers to the amount of blood being pumped out of the left ventricle each time it contracts.
That’s important because your body needs that oxygen and nutrient-rich blood freely circulating at its best.
Result: You feel comfortable when participating in activities.
HOWEVER: You can have a “Normal” ejection fraction reading and still have heart failure.
If the heart muscle has become so thick and stiff that the ventricle holds a smaller-than-usual volume of blood, it might still seem to pump out a normal percentage of the blood that enters it.
- In reality, though, the total amount of blood pumped isn’t enough to meet your body’s needs.
- Your heart is not working as well as it should.
Result: Symptoms may start to become noticeable with activity.
- Fatigue (feeling tired all the time)
- Shortness of breath
- Swelling in the feet
If your heart’s Ejection Fraction is low, it can also cause a very rapid heartbeat, (Tachycardia) which can make your heart pump ineffectively. If you have heart disease, your doctor should check your EF periodically, closely monitoring your condition.
An Ejection Fraction from 41% to 49% may be considered “borderline” but does not always show that a person is developing heart failure. Sometimes, it may indicate damage, perhaps from a previous heart attack.
With a “Reduced” Ejection Fraction, 40% or less blood is pumped out during each contraction.
Moderate to severe heart failure increases the risk of life-threatening heartbeats and a condition called “cardiac dysynchrony” which means that the right and left ventricles are not pumping in unison.
If you have an Ejection Fraction of less than 35%, you have a greater risk of life-threatening irregular heartbeats that can cause sudden cardiac arrest/death.
Your doctor may talk to you about treatment with an implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy (CRT).
Your doctor may also recommend specific medications or other treatments, depending on how advanced your heart failure is.
Less common treatment options include a heart transplant or a ventricular assist device (VAD), which is a mechanical pump.
If your quality of life is very poor or your doctor has told you that your condition is very severe, please ask about other possible treatments.
Your heart’s Ejection Fraction may also be too high:
- If it’s higher than 75%, it may show a heart condition like hypertrophic cardiomyopathy.
Ejection Fraction can be measured by using either:
- An Echocardiogram (Echo) – this is the most common way.
- Magnetic-Resonance-Imaging (MRI) scan of the heart
- Nuclear Medicine Scan of the heart; also called a Nuclear Stress Test
Keep in mind that your heart’s ejection fraction is just one measure of heart function. Even with a normal ejection fraction, overall heart function may not be normal.
As always, I urge you to speak with your physician to figure, based on your current health, how often you need screening tests for heart disease.