Understanding Heart Failure: What Is Ejection Fraction?
Ejection fraction is one way to measure how well your heart is pumping.
Your heart health impacts your entire body. When it's working well, it pumps oxygen-rich blood to all the other tissue in your body. When it’s not working as well as it could, it could affect multiple parts of your health. One of the ways to measure how well the heart is pumping is called ejection fraction.
What is ejection fraction?
Ejection fraction measures the amount of blood that leaves the heart with each beat.
In between beats, the left ventricle fills with blood. This is the last chamber of the heart that blood moves through before moving out to the rest of the body. When the heart beats, a certain amount of that blood exits the left ventricle.
In other words, your ejection fraction is how much blood is “ejected” (pushed out) from the left ventricle divided by how much blood was in there to begin with. This gives you a percentage. It’s never 100 percent of the blood, even in a healthy heart.
What is a healthy ejection fraction?
Ejection fraction can fall in three categories:
Normal ejection fraction is between 50 and 70 percent
Borderline ejection fraction is between 41 and 49 percent
Reduced ejection fraction is 40 percent or lower
An ejection fraction above 75 percent is less common and may be a sign of another heart condition, such as hypertrophic cardiomyopathy.
What is heart failure with reduced ejection fraction?
If you have a reduced ejection fraction, this may be a sign that your heart is not pumping as well as it should. This is one sign of heart failure.
Heart failure is when the heart muscle has become weak and can’t pump blood well enough to meet the body’s needs. Your ejection fraction can help diagnose heart failure, but it can also help monitor how well your heart failure treatment is working.
Symptoms of heart failure with reduced ejection fraction include:
Difficulty breathing, especially when lying flat or with exertion
Breathlessness
Swelling in the legs, ankles, and feet
Fatigue
Unintended weight loss or gain
Weakness
Heart palpitations
Fainting
Dizziness
These symptoms usually worsen with physical activity. When heart failure is severe, they may occur even at rest.
What is heart failure with preserved ejection fraction?
It’s possible to have heart failure despite a normal ejection fraction. Usually, this means that the heart is not properly filling with blood in between beats. This is called heart failure with preserved ejection fraction.
Is it possible to improve your ejection fraction?
Treating heart failure may help improve your ejection fraction. This may in turn improve your symptoms. Treatment may also help slow or stop the progression of heart failure.
Talk to your doctor for more information about your ejection fraction and how to manage it. They can share more tips for heart-healthy habits and help you find the right medication regimen to feel better.
- Michelle Weisfelner Bloom, MD, FACC, FHFSADr. Bloom is a Cardiologist, an Associate Professor of Medicine at Stony Brook University Medical Center, a fellow of the American College of Cardiology and the Heart Failure Society of America.
References
American Heart Association. (2023). Ejection fraction heart failure measurement.
Centers for Disease Control and Prevention. (2024). Heart failure.
Hajouli, S., et al. (2024). Heart failure and ejection fraction. StatPearls [Internet].
Kosaraju, A., et al. (2023). Left ventricular ejection fraction. StatPearls [Internet].
National Heart, Lung, and Blood Institute. (2022). Heart failure treatment.