Echocardiogram Ejection Fraction Range

Ejection fraction is important for healthcare professionals, as it helps them know how well the heart is pumping. It helps to detect and track an impending heart failure. Expressed as a percentage, ejection fraction is a measure of the blood that the heart pumps out with each contraction.

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An echocardiogram helps doctors assess the heart's efficiency by estimating the values it provides. The standard value of ejection fraction (EF) is 50%-70%. Gauze helps you accurately evaluate your patient’s EF.

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In this blog, we will explore the concepts of normal and abnormal values, along with their respective indications.

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What is ejection fraction?

Before we understand what ejection fraction is, we must first understand how blood travels through our body.

• Blood enters the heart through the right atrium from two large blood vessels, the inferior and superior vena cava.
• A pause occurs when blood flows through a valve down to the ventricles between heartbeats.
• After the ventricles are filled, the next heartbeat pumps a part of the blood out to the body.

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With every contraction, the ventricles pump out blood, a measurement known as the ejection fraction.

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Ejection fraction in heart failure diagnosis

• Heart failure with preserved ejection fraction (HFpEF) is a type of diastolic heart failure. The ventricles do not relax during ventricular filling and are not filled with blood.
• Heart failure with reduced ejection fraction (HFrEF) is a type of systolic heart failure in which the heart muscle contracts ineffectively, resulting in less oxygen-rich blood being pumped out of the body.

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Types of ejection fraction

• Left ventricular ejection fraction (LVEF)

LVEF determines how efficiently the left ventricle of the heart pumps oxygen-rich blood to the rest of the body.

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• Right ventricular ejection fraction (RVEF)

It measures the amount of deoxygenated blood pumped from the right side of the heart to the lungs.

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What do the ejection fraction numbers mean?

Echocardiography, cardiac MRI, and nuclear medicine scans help determine the ejection fraction. A normal ejection fraction is considered to be fifty percent or higher.

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The formula to calculate ejection fraction is

EF=(SV/EDV) X100

Where

• SV is the stroke volume
• EDV is the total amount of blood in the ventricle
• To express as a percentage, it is multiplied by 100

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In simpler words, ejection fraction is the percentage of blood pumped out of the ventricle after contraction.

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The numbers indicate that the lower the ejection fraction, the weaker the heart’s pumping ability, which is typically observed in people with severe heart failure.

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Normal Ejection fraction range

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Why does EF matter? 

EF signifies the severity of the disease when the range of values differs.

• 40% and 49%:  The heart’s pumping ability is below normal. There may be heart failure symptoms, particularly with physical activity, but they don't occur at rest.
• 39% or less: Is heart failure with reduced ejection fraction. It means the pumping ability is below normal, and there is a risk of life-threatening complications such as cardiac arrest. The symptoms are severe and persist even when you are resting.
• A higher ejection fraction above 70% or 75% is rare but can be dangerous. It occurs in cardiomyopathy.

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How does reduced ejection fraction happen?

Healthy muscles are essential for pumping blood. Conditions that weaken or damage heart muscles make contractions difficult and less effective; as a result, the heart has to work harder. The extra work causes swelling or scarring that affects the ventricles and their ability to fill and pump. With a decline in heart function, the ejection fraction worsens, and you become severely ill.

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In heart failure with preserved ejection fraction, the heart muscles work well but hold less blood compared to a normal heart. It occurs when the muscles become stiff or thick, and the ventricles shrink inward. Thus, even when the heart contracts properly, it does not pump sufficient blood to meet the body's needs.

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Risk factors

Knowing your ejection fraction is particularly helpful if you have other risk factors that can increase your likelihood of developing heart failure, as it can damage the heart.

• Cancer or conditions that require chemotherapy 
• Heart attack
• Congenital heart disease
• Heart valve disease
• Myocarditis
• High blood pressure
• Ventricular arrhythmia

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Symptoms of a low ejection fraction are 

• Confusion
• Fatigue
• Palpitations
• Nausea
• Shortness of breath
• Swelling in the ankles or feet
• Weakness

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Ways to improve Low EF

• Managing risk factors helps to improve EF and heart failure

• Risk factors for heart failure are

• Hypertension or high blood pressure

• Diabetes

• Metabolic syndrome

• Physical activity

• Walking is a good, safe way to begin physical activity and gradually work up to 20 to 30 minutes of cardio a day.

• Weight management

• Track and respond to weight changes. Maintaining a healthy body weight makes it easy for the heart to circulate blood.

• Reduce salt intake

• Manage stress

• Avoid or quit smoking, alcohol, and amphetamines.

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Conclusion

Ejection fraction is a crucial indicator of the heart's pumping efficiency. The changes in the EF indicate different types of heart failure. Understanding ejection fraction numbers, recognizing symptoms, and addressing risk factors through lifestyle changes and medical care improve outcomes. Regular follow-ups, healthy habits, and essential steps are key to managing heart health effectively.