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Everything You Should Know About Ejection Fraction

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Everything You Should Know About Ejection Fraction


When your heart beats, it pumps out the blood into your body with two lower muscular chambers which are known as the left and right ventricles. It requires more than one contraction to pump all the blood from your heart. Ejection fraction (EF) is the measurement used by the doctors at the health screening clinic to know the percentage of blood flow out of these ventricles through each contraction.

How ejection fraction is calculated

The left ventricle is the one measured for ejection fraction or EF that performs heavy lifting in the body and pumping blood to all major organs. However, research suggests that the right ventricle should not be ignored at the time of determining EF.

The accurate reading of your left ventricle EF (LVEF) can be done with different imaging techniques. The most common EF testing measures include the following:

  • Echocardiogram – An echocardiogram uses sound waves for taking the images of your heart. According to the research, 3-D images offer the most accurate readings.
  • Cardiac magnetic resonance imagining (C-MRI) – A C-MRI is actually an image-based test that uses radio waves, magnetic fields and a computer to form detailed images of your heart.
  • Cardiac catheterization – During this method, your doctor will put in a hollow tube into the large blood vessel to examine your heart function. In the catheterization, coronary angiography will be done and a dye is injected into the catheter. Then an X-ray evaluates your blood flow throughout the heart.
  • Cardiac nuclear medicine scan – Some traces of radioactive materials get injected into the bloodstream. They will be detected by cameras that produce the images of your heart and its mechanisms.
  • Cardiac CT scan – This X-ray method is quick and is usually used when other tests are uncertain.

What ejection fraction or EF results mean

The normal LVEF reading for the adults who are above 20 years old is usually 53 to 73 percent. If the LVEF is less than 53 percent for women and 52 percent for men, then this is considered low. The RVEF which is less than 45 percent is the probable indicator of heart issues. There are two common issues that need to be addressed:

  • HFrEF (systolic dysfunction) – This is heart failure with decreased ejection fraction. This takes place when one of the four chambers of your heart does not contract properly. Some symptoms may include – heart palpitations, shortness of breath or exhaustion.
  • HFpEF (diastolic dysfunction) – This is heart failure that has normal or preserved ejection fraction. This can occur when the ventricles are not relaxed properly and don’t eject enough blood from the heart into the body. Certain symptoms for HFpEF are – shortness of breath at the time of exercise and fatigue. HFpEF may be the reason for diabetes, hypertension or aging.

Causes of low EF

As you grow older, your heart will age too meaning that the walls of your heart will thicken and lose some of their capacity to contract as well as relax with the passing of years. But, the low EF reading may denote some kind of heart damage such as:

  • Cardiomyopathy – The condition will make your heart tissues thick.
  • Heart attack – This generally takes place when the muscles of your heart get damaged and one or more arteries become blocked.
  • Coronary artery disease – This condition blocks or narrows the left and right arteries of your heart thus, making blood flow to the heart extremely difficult.
  • Systolic heart failure – This occurs when your left ventricle cannot pump a sufficient amount of blood to the body.
  • Heart valve disease – This occurs when the valves of your heart do not open and close properly and blood cannot flow easily in the heart.

Causes of high EF

If the EF reading is high, then this may denote a heart condition called hypertrophic cardiomyopathy (HC). The condition unusually thickens some parts of the heart muscle without any specific cause. HC is usually genetic and it is quite difficult to diagnose as many people may lead a symptom-free life.

In the case of a small number of people, HC may lead to serious unusual heart rhythms or arrhythmias that need immediate treatment. If you have a family record of HC, inform your doctor about it so that they can monitor your condition in due course of time.

Different treatment options for unusual EF

Some treatment options for irregular EF are the following:

  • Angiotensin converting enzyme (ACE) inhibitors, beta-blockers or angiotensin II receptor blockers (ARBs) – The medications may decrease the amount of hormones that can weaken the muscles of your heart. They may even slow down the progression of heart disease.
  • Diuretics – These medications enable you to overcome excess fluid that might be the reason for shortness of breath and swelling.
  • Eplerenone or spironolactone – These agents may help to get rid of excess fluid and lessen the stiffening of the heart.
  • Biventricular pacemaker – This pacemaker can synchronize the contractions of the left and right ventricles so that they work to their highest capacity.
  • Implantable cardiac defibrillator – The device may be directly implanted into the chest that sends small electrical triggers to the heart so that it beats regularly.
  • Hydralazine-nitrate – These two medications have attained great success in decreasing blood pressure in people who have some symptoms while taking ARBs, beta-blockers and ACE.

Thus, the viewpoint for an unusual ejection fraction is encouraging. But in most cases, you may manage the symptoms by listening to the advice of your doctor who provides health screening services. This way, you can continue leading a normal life with proper care and medication. Make sure you eat a well-balanced low-fat diet and take lots of leafy green vegetables. Do your regular exercise and have a great sleep and consistent sleeping schedule to take good care of your health.

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