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· 22 Nov 2021

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What is the Normal Ejection Fraction?

#ejectionfraction
#Ejection fraction (EF) is the measurement of the percentage of blood that leaves your heart with each contraction. The heart can contract and relax. When it contracts, it pumps out blood either to the lungs for oxygenation or to the rest of the body. This blood is ejected from the two lower chambers, known as ventricles. When your heart relaxes, the ventricles are filled with blood. No matter how much force is there, the heart can never pump out all blood out of the ventricles 100%. This explains the origin of the term “ejection fraction”. So, EF shows the amount of blood that is ejected out of a filled ventricle with each heartbeat. Ejection fraction is an important measure of how well the heart is functioning. For instance, a low fraction ejection could show heart failure. That’s why doctors depend on ejection fraction measures to make some critical medical decisions. From the readings, the doctor can mention one of the following things:

1. Preserved ejection fraction (HFpEF). This is also called diastolic heart failure. It happens when the heart muscles are contracting normally, but ventricles do not relax as expected. Ventricles fail to relax during the ventricular filling.

2. Reduced ejection fraction(HFrEF). We also call this systolic heart failure. It happens when the heart muscles cannot contract effectively. In return, this hinders oxygenated blood from the heart to reach the rest of the body. The body receives less blood and therefore cannot function properly.  


How is Ejection Fraction Measured?

EF is measured in a few ways in which are:
●    Echocardiogram: This uses sound waves to take heart images. It gives the most accurate and the best readings.
●    Cardiac MRI (C-MRI): This is a test based on images that uses a wide range of magnetic fields, radio waves, and computer programs to capture images inside your heart.
●    Cardiac CT scan: This is a procedure based on X-rays to give the size of your heart. It also shows the heart’s functioning capabilities.
●    Cardiac catheterization: This is a procedure where the doctor inserts a catheter into your major blood vessels to monitor your heart’s functioning.
●    Cardiac nuclear medicine scan: This procedure is done to capture the heart’s images and mechanisms of function. It uses radioactive dye injected into your bloodstream.


What Are the Ranges of Ejection Fraction?

After the doctor has measured the ejection fraction, he/she then compares the values to the normal ranges. Each value range says something about your heart and it’s what determines the type of treatment you’ll receive. They are:

High Ejection Fraction. This is a measurement above 72% in men and above 74% in women. Being this high may show a heart condition called hypertrophic cardiomyopathy. This condition makes the heart muscles thicken, and this interferes with the heart’s pumping ability. This causes a sudden cardiac arrest.

Normal Ejection Fraction. The normal EF range is between 50-70% of the blood ejected by the left ventricle. A normal range means that your heart is pumping the expected amount of blood with each contraction. You can have a normal EF and still have a heart failure with preserved ejection fraction(HFpEF).

Mildly reduced Ejection Fraction. This ejection fraction ranges between 41-41% in men and between 41-53% in women. If someone has these readings, it can mean a sign of heart damage, probably from the previous heart attack.

Low Ejection Fraction.
This is when the EF is under 40%. Having a low ejection fraction shows heart failure or cardiomyopathy. Cardiomyopathy is a disease that affects the heart muscles. People who have a low EF cannot pump enough blood to other parts of the body. As a result, such people experience fatigue, shortness of breath, swollen feet, and the inability to perform activities of daily living.


What Causes Abnormal Ejection Fraction?

1. Reduced fraction ejection: As people grow old, the body mechanisms and organs go shutting down as well. One of the most affected organs is the heart because its walls thicken. Heart muscles also reduce their ability to contract and relax. This is when doctors say the heart is damaged and the following conditions can cause this:
●    Defective heart valves. The heart valves are important as they control the outflow and inflow of blood out of the heart. Any disease that affects these valves can impair their ability to function properly. One valve or both may not open and close well, disrupting the flow of blood.
●    Heart attack. This happens when one or more arteries are blocked. This, in return, makes it hard for blood to reach the heart muscles and affects them. Also, coronary artery disease can also narrow the arteries and prevent blood from reaching the heart properly.
●    Cardiomyopathy is a condition that weakens the heart muscles. This happens when these muscles become dilated or become thick, making it hard for your heart to pump blood to the rest of the body.  

2. Increased ejection fraction. Reduced fraction ejection is caused by a condition called hypertrophic cardiomyopathy. This disease makes the heart muscles thicken abnormally for no known cause. Most doctors argue that the disease runs in families and so if you come from such families, it’s good to go for regular checkups. People with hypertrophic cardiomyopathy may also experience serious abnormal heart rhythms known as arrhythmias. Most times, people go to the hospital with arrhythmias, only to be diagnosed with hypertrophic cardiomyopathy.


How to Improve Your Ejection Fraction.

When the EF is not within the normal range, medical treatment is recommendable. However, there are a few tips that can help you recover quickly. You can do:

Limit the salt intake to 2, 300 milligrams per day. You can as well decide to cook at home because most of the packed foods contain added salt, which is unhealthy. Sometimes foods with high sodium concentrations do not even taste like they have any salt.

Do exercises. Working out at least 30 minutes a day may put you in a safer position to avoid cardiac conditions that may affect your EF.

Managing stress may be a key factor in keeping your EF normal. Stress has a direct negative impact on the heart and if not well checked, it’s easy to be diagnosed with a heart problem.

Avoid smoking, alcohol, and abuse of drugs. Consumption of these products exposes someone at risk of developing hypertension, heart failure, heart attack, etc., all of which can either raise or lower your ejection fraction.

Manage fluid intake. People suffering from hypertension or other cardiac diseases must regulate their fluid intake. Why? Too much fluid in the body can raise blood pressure, which in return affects your ejection fraction. Also, too little water exposes you to dehydration, a circumstance that can affect your general health as well.


The Bottom Line

Ejection fraction is an important determinant of your heart’s status. It measures the percentage of blood that leaves the left ventricle with each contraction. The normal ejection fraction ranges between 50-72 percent for men and between 54-74 percent for women. When the ejection fraction is low or high, it may indicate heart failure or an underlying cardiac condition. Abnormal ejection fractions may look worrying to some people but they’re 100% manageable. You can manage them with proper treatment, lifestyle modifications, and regular checkups. With all these measures in place, people can live healthy lives.