Why Your Ejection Fraction Matters With A Heart Condition

If you’ve heard the term ejection fraction, you or someone you know probably has a heart condition.

Ejection fraction is a measurement of how strong a person’s heart pumps blood to their body with each beat. It’s an important way doctors understand what’s happening to a person’s heart when it’s not working the way it should. They can also use it to determine what treatment is needed for a person’s heart condition and then be able to monitor if it’s working.

Read below to learn more about how the heart works, what ejection fraction is and symptoms of it, and what can be done to treat it.

A Simplified Explanation How The Heart Works

Your heart has two “tanks” for blood – the right and left atrium. Below each atrium is a smaller pumping chamber called a ventricle. When each ventricle contracts and releases, blood in the right atrium gets pushed (ejected) to the lungs to get oxygenated, while blood in the left atrium gets pushed (ejected) to the arteries to carry oxygen through your body.

Understanding Ejection Fraction

Ejection fraction is a measurement that shows the percentage of blood that leaves a person’s heart with each beat. A normal, healthy heart will never completely empty, but it will pump out 55-70 percent of the blood that’s inside it. An ejection fraction of 55-70 percent is normal; 40-55 percent is below normal. Anything less than 40 percent may indicate heart failure, and below 35 percent there’s a risk for life-threating arrhythmias (abnormal heart beat).

Ejection fraction is usually measured with an echocardiogram – ultrasound images of the heart’s chambers, valves, and blood vessels. It’s painless and often done right in the doctor’s office. It can also be measured with cardiac catheterization, MRI, nuclear medicine scan, or a CT scan.

Below are two videos that show the difference between a heart with a normal ejection fraction and a heart with a low ejection fraction.



In most cases, when you hear the word ejection fraction, it’s referring to left ventricular ejection fraction, or LVEF. If you recall from above, it’s the left ventricle that contracts and releases blood into the left atrium that gets pushed (ejected) to the arteries to carry oxygen through the body.

Low ejection fraction symptoms

There are two types of heart failure:

  • Diastolic heart failure which occurs when the heart muscle becomes stiff and unable to relax properly during the heartbeat cycle. This makes the heart unable to fill with blood like it normally should. This can happen without affecting ejection fraction.
  • Systolic heart failure which occurs when the heart muscle weakens and doesn’t contract hard enough to push blood throughout the body. This happens when left ventricular ejection fraction is less than 40.

Symptoms of low ejection fraction include:

  • Fatigue
  • Feelings of fullness or bloating in the stomach
  • Heart palpitations
  • Loss of appetite or nausea
  • Reduced ability to exercise
  • Shortness of breath
  • Swelling in the feet , ankles, or abdomen

Treating Low Ejection Fraction

For people with a low ejection fraction, treatment options usually include lifestyle changes and prescription medication:

  • Lifestyle changes involve cutting out alcohol or illegal drug use, exercising regularly, monitoring weight daily, quitting smoking, reducing salt intake, and restricting fluids.
  • Prescription medications can be used to relax blood vessels, slow the heart, increase the force of contractions, or remove excess fluid that leads to swelling or shortness of breath.

Some individuals may need procedures such as an implanted pacemaker to control the heart’s rhythm, a defibrillator to shock it back in rhythm if it falls out of rhythm, or a ventricular assist device to help pull the blood from the ventricle. A heart transplant may also be an option.

The Takeaway

If you’re someone with a heart condition, it’s important to know your ejection fraction. It can help doctors determine the right course of treatment for you, and have the ability to monitor if it’s working.

Meet the Author

Bijoy K. Khandheria, MD is a Cardiologist at Aurora St. Luke’s Medical Center in Milwaukee, WI. He is also the Medical Director of Global Health and Executive Program at Aurora St. Luke's. Dr. Khandheria has published over 200 papers in peer reviewed journal and co-edited 3 books.

Read more posts from this author

The information presented in this site is intended for general information and educational purposes. It is not intended to replace the advice of your own physician. Contact your physician if you believe you have a health problem.

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