What is ejection fraction?

You might know a lot about the heart, but you may not have heard of something that doctors know is really important. Ejection fraction is a measurement that indicates how well the heart is working.

“Cardiologists put a lot of emphasis on ejection fraction because it’s a number one predictor of prognosis in cardiology,” says Dr. Joaquin Solis, an interventional cardiologist at Aurora St. Luke’s Medical Center in Milwaukee, WI.

“Ejection fraction is the amount of blood that is pumped with every heartbeat,” Dr. Solis says. “This number tracks how much blood the heart is pumping out with each contraction and is described as a percentage. If you’re healthy, your ejection fraction is generally between 55% and 70%.”

“For instance, an ejection fraction of 60% means your heart is pumping 60% of your blood out of your left ventricle every time your heart beats,” he says. “If your ejection fraction is less than 50%, it means your heart isn’t functioning as well as it could. Ejection fraction between 40-50% signifies mild dysfunction, between 30-40% moderate dysfunction, and less than 30% is severely reduced ejection fraction.”

Do you know what your ejection fraction is and when you should see a doctor?

If you have a few of the symptoms listed below, you may want to talk to primary care doctor or a cardiologist:

  • Fatigue
  • Shortness of breath
  • Not being able to catch your breath when you are laying down
  • Fluid retention -0 swollen legs and/or abdomen
  • Heart palpitations
  • Loss of appetite
  • Nausea

There are many ways to measure ejection fraction, but the most common test your doctor will order is an echocardiogram. The test shows the size of the heart before and after the beat and gives the percentage.

Many different heart conditions can lead to low ejection fraction, such as:

  • Cardiomyopathy: disease of the heart muscle
  • Coronary artery disease
  • Uncontrolled hypertension
  • Valvular heart disease

“The treatment is in general very similar for all conditions. Doctors prescribe medications that have shown in multiple studies to improve ejection fraction resulting in better survival rate” says Dr. Solis. “If you have coronary artery disease or severe blockages in the arteries, then an intervention to remove them can help, if you have a malfunctioning valve sometimes fixing the valve can help – it depends what an underlying cause of low ejection fraction is.”

“In severe cases, patients should look for a tertiary center, such as St. Luke’s, that has the equipment and expertise to treat most complex cases, including those who need a heart transplant,” Dr. Solis says. “The sooner you are treated, the better the prognosis.”

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