Your EF can help doctors figure out if you have certain heart problems -- especially heart failure. Despite the scary-sounding name, heart failure doesn’t mean your heart stops, it just means it can’t pump as much blood as your body needs. Your EF number will also help the doctor decide which treatments are best for you, and if your treatment is working.
How Is EF Measured?
There are a few ways your doctor can find out your EF percentage. The most common is an echocardiogram, but other tests are sometimes used:
Echocardiogram. A technologist places a hand-held wand over your chest. It uses ultrasound waves to take pictures of your heart.
MRI. You’ll lie down on a bed that slides into a large magnetic tube. MRI uses a magnet, radio waves, and a computer to create clear pictures of the inside of your body, in this case your heart.
Nuclear stress test (you may also hear it called a multigated acquisition scan, or MUGA). The doctor injects a small amount of radioactive dye into a vein. As it moves through your heart, a camera makes images of your heartbeats.
What Should My EF Be?
Many consider a normal EF to be 55% to75%. If yours is 50% or lower, it’s a sign your heart -- again, usually your left ventricle -- may not pump out enough blood.
The gray area seems to be when your EF is between 50% and 55%. Some experts call this borderline.
A normal EF doesn’t always mean your heart is healthy. You could have heart failure with preserved ejection fraction, or HFpEF. It happens when your heart muscle thickens to the point that the left ventricle holds a smaller-than-normal amount of blood. Even if that chamber pumps the way it should, it doesn’t release as much oxygen-rich blood as your body needs.
Understanding Low EF
It means there’s a problem with your heart. If your EF is below 50%, you may be on the way to heart failure. Or you could have another heart issue, like damage from a heart attack.
An ejection fraction of 40% or lower can also signal cardiomyopathy, a term that covers several diseases of the heart muscle. When your EF is low, symptoms can include:
- Fatigue (feeling tired all the time)
- Shortness of breath
- Rapid heartbeat
- Swollen feet, legs, or belly
Can EF Get Better?
There are medications that can raise your EF and improve symptoms. Your doctor may suggest:
- Inotropes, like digoxin: They help your heart contract better.
- Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs): They ease stress on your heart muscle.
- Beta-blockers: They improve symptoms by slowing your heart rate a bit to lower its workload.
- Diuretics: They help your body get rid of extra fluid from swelling.
- Mineralocorticoid receptor antagonist: A type of diuretic that helps your body get rid of salt and fluid without losing potassium.
Doctors also suggest these lifestyle changes for people with low EF:
- Get regular physical activity at a level your doctor approves.
- Take daily relaxation/rest periods.
- Limit salt and excess fluids.
- Cut out alcohol and tobacco.
An implantable cardiac defibrillator, a device that keeps your heart beating, can help some people with a low EF live longer.
What to Ask Your Doctor
It’s smart to play an active role in managing your health, especially if you have a low EF. Keep up with your appointments. Have your doctor explain your condition and treatment options. Here’s a list of questions you may want to ask:
- What does my EF number mean for my health?
- When should I have my EF tested again?
- Should I take medications or make lifestyle changes?
- Do I need any other tests?
- Do you specialize in heart rhythm problems? If not, should I see a doctor who does?