Have you ever wondered how efficiently, or rather how well, your heart pumps blood? It's important for us all to be aware of this amazing organ in our bodies. Today we're going to talk about a very important measurement of the heart's pumping ability, one that doctors often talk about. That's the heart's ejection fraction ( Ejection Fraction ) . You may have heard these words, especially the English word `(Ejection Fraction)`, from a doctor, or you may have seen them in some report. So, very simply, so that you can understand, what is this, why is it so important, how is it measured, what happens if this value increases or decreases, we will talk about everything today.
What is the pumping efficiency of the heart (Ejection Fraction)?
Simply put, Ejection Fraction is a measure of how well your heart pumps blood. In more detail, it is the amount of blood that is ejected from the lower chambers of the heart (we call them ventricles) during each beat.
Think of it like a water tank. When the tank is full, it's like how much water comes out of it when you turn on the motor once.
Let's take a look at how blood travels through the heart.
To properly understand this (Ejection Fraction), it's good to have a little idea of how blood circulates inside our heart .
1. First, the oxygenated and purified blood from the lungs enters the upper left chamber of the heart (we call it the left atrium).
2. Then, during the short pause between heartbeats, this oxygen-rich blood flows through a gate (valve) in the heart into the main pumping chamber (the left ventricle) on the lower left side of the heart. This left ventricle is the most powerful muscle in the heart, because it has to pump blood to the entire body.
3. When the left ventricle is fully filled with blood, with the next heartbeat, a certain percentage of this blood is pumped through the aorta to the entire body.
This last one, the Ejection Fraction, is the amount of blood pumped out of the left ventricle to the body in one heartbeat, as a percentage of the total blood volume in that ventricle before it beat. Do you understand?
What should the normal Ejection Fraction value be?
A healthy heart's Ejection Fraction is usually between 50% and 70% . This means that between 50% and 70% of the blood in your left ventricle is pumped out to the body with each heartbeat.
But here's a little thing. Even though some people's (Ejection Fraction) values are in the normal range, they still have heart disease (`( There may be a condition called `(Heart Failure with preserved Ejection Fraction - HFpEF)`. We will talk about it in more detail later.
Why is it important for you to know this (Ejection Fraction) value?
Your Ejection Fraction value is an important indicator of how well your heart is working. A low value usually means that you have heart failure, or are at risk for it. That's why doctors are concerned about this value.
Are there types of Ejection Fraction?
Yes, there are two main types of Ejection Fraction that we are talking about. Those are measurements related to the left side and the right side of the heart.
- Left Ventricular Ejection Fraction ( LVEF ):
This LVEF value is usually called (Ejection Fraction). Because, the left ventricle of the heart pumps oxygen-rich blood to the organs of the whole body. So, this LVEF value shows how much oxygen-rich blood is sent to the body from the left ventricle in one heartbeat. This LVEF value is very helpful in determining whether there is any weakness in the functioning of the left side of the heart, and if so, how severe it is.
- Right Ventricular Ejection Fraction (RVEF):
This measures the amount of oxygen-poor blood being pumped from the right side of the heart, the right ventricle, to the lungs to get oxygen. This value is important for someone with right-sided heart failure (`( Right-Sided Heart Failure )`). However, this condition is not as common as left-sided heart failure.
What do these (Ejection Fraction) values mean?
A low Ejection Fraction often means that your heart is not pumping blood well enough. This is common in people with severe heart failure. Ejection Fraction can also be low in the early stages of heart failure. Treatment options depend on how far your Ejection Fraction is from normal.
- Between 40% and 49% (Mid-range Ejection Fraction): This means that the heart's pumping ability is slightly lower than normal. You may not have any symptoms of heart disease. Or, you may have no symptoms at rest and only experience symptoms during exercise.
- 39% or less (Heart Failure with reduced Ejection Fraction - HFrEF): This means that the heart's pumping ability is significantly lower than normal. As the Ejection Fraction value decreases, the risk of life-threatening complications such as sudden cardiac arrest (`(Cardiac Arrest)`) increases. Symptoms can be severe, and even just sitting down can be uncomfortable.
How does heart failure and normal (Ejection Fraction) (HFpEF) affect you?
As we discussed earlier, sometimes the Ejection Fraction is normal but the heart can still be in a state of ``Heart Failure''. This is called ``Heart Failure with preserved Ejection Fraction - HFpEF'' or ``Diastolic Heart Failure''.
What happens in this case is that the left ventricle of the heart becomes thickened (`(thickening)`) or stiff (`(stiffness)`), so that the ventricle cannot fill with blood properly. Think of it like a balloon. A new balloon inflates easily and holds a lot of air. But an old, stiff balloon inflates with difficulty and holds only a small amount of air, right? It's like that.
So, because the amount of blood inside the cell is low, even if a normal percentage (50%-70%) of it is pumped, the total amount of blood needed by the body is not delivered. The result is the symptoms of heart attack.
You may be at risk for `(HFpEF)` with conditions like:
- Fluid accumulation around the heart (`(Cardiac Tamponade)`)
- Coronary Artery Disease (`(Coronary Artery Disease)`)
- Heart Valve Disease
- High blood pressure (`(High Blood Pressure)`)
What are the causes of a low Ejection Fraction?
Healthy heart muscle tissue is needed for the cells that pump blood throughout the body to contract. Any condition that weakens or damages the heart muscle can make this contraction incomplete and less efficient.
The heart then has to work harder to do its job. This extra strain can cause the heart to swell or scar tissue to form, reducing its ability to fill with blood and pump.
You may not notice it at first if your Ejection Fraction value drops slightly. But as your heart function gradually decreases and your Ejection Fraction value gets worse, you can become seriously ill.
How does it feel to have a low Ejection Fraction?
As your Ejection Fraction value decreases, heart attack symptoms may become more severe. You may experience things like:
- Confusion, difficulty concentrating
- Constant fatigue (`(Fatigue)`)
- Feeling of heart palpitations, chest pain (`(Heart Palpitations)`)
- Nausea
- Difficulty breathing (Dyspnea), especially when lying down
- Fluid retention (swelling) in the abdomen or legs
- Weakness
If you have one or more of these symptoms, it is very important to seek medical advice immediately.
What if the Ejection Fraction value is higher than normal?
It is very rare for an Ejection Fraction value to be 75% or higher. But if it does occur, it can be dangerous. People with a heart muscle disease called ``Hypertrophic Cardiomyopathy`` may sometimes see such a high value.
Who should measure this (Ejection Fraction)?
If you have a medical condition that can cause heart failure, or are at risk for it, it is very useful to know your Ejection Fraction value.
Doctors recommend measuring Ejection Fraction in cases like these:
- In conditions such as ``ATTR Amyloidosis'' that affect the heart.
- People who are taking chemotherapy for cancer or other medical conditions. Because some chemotherapy drugs can damage the heart (cardiotoxicity), it is important to monitor heart function.
- People with congenital heart disease.
- Someone who has had a heart attack.
- People with heart valve disease.
- People with heart muscle inflammation (`(Myocarditis)`).
- People with severe high blood pressure (`(Severe High Blood Pressure)`).
- People with ventricular arrhythmias.
How is the Ejection Fraction value used for treatment?
This value helps doctors decide which heart failure treatment is best for you. Checking your ejection fraction periodically during treatment can help to see if your heart function is improving.
Treatments for heart failure may include:
- A specialized pacemaker (`(Biventricular Pacemaker)`)
- Heart Failure Medications
- Heart Transplant (`(Heart Transplant)`) - In the most severe cases
- Heart Valve Repair or Replacement (`(Heart Valve Repair or Replacement)`)
- An implantable cardioverter defibrillator (ICD)
How is Ejection Fraction measured?
There are several ways to measure Ejection Fraction. The most commonly used method is an ultrasound scan of the heart, called an Echocardiogram. This is a painless, simple test.
In addition, there are several other tests that can measure Ejection Fraction:
- Cardiac Catheterization (`(Cardiac Catheterization)`)
- Cardiac Computed Tomography (CT scan)
- Magnetic resonance imaging of the heart (`(Heart MRI)`)
- Multigated Acquisition Scan (MUGA scan), also known as Nuclear Stress Test.
Can I improve my Ejection Fraction?
Yes, absolutely. Treatment for heart failure focuses on the underlying cause of a low Ejection Fraction. For example, if your heart failure is caused by an irregular heartbeat (arrhythmia), you may benefit from a biventricular pacemaker. People with heart failure due to other causes, such as high blood pressure, may need medication.
Also, you can take a few extra steps to reduce the strain on your heart and get the most out of your treatment.
Remember, following medical advice is the most important thing.
However, you can also do these things:
- Increase physical activity: As per your doctor's advice, you can safely start exercising. A cardiac rehabilitation program can be very helpful in this.
- Maintaining a healthy weight: Excess weight puts extra strain on the heart.
- Limit salt (sodium) and fluids in your diet: Do this according to medical advice.
- Quitting harmful habits like smoking, drugs, and alcohol: These directly harm the heart.
How do I know if my Ejection Fraction value is improving?
If you have a low Ejection Fraction, you will have regular appointments with your doctor to monitor it. It is important to keep all of these appointments, even if you feel unwell.
If your symptoms are decreasing, it could be a sign that your Ejection Fraction is improving. However, your symptoms may be getting worse, or new symptoms may appear. These things could mean that your Ejection Fraction is getting worse.
If you experience any of these symptoms, call your doctor immediately without waiting until your next appointment:
- Difficulty breathing, especially when lying down.
- Feeling of unusually fast heartbeat.
- Loss of appetite or vomiting.
- Sudden weight change (this may be a sign of water retention).
- Feeling weak or dizzy for no reason.
How often should the Ejection Fraction value be measured?
Doctors may be concerned about your Ejection Fraction value in the following situations:
- If you have symptoms of heart disease.
- If you have a heart attack or other condition that affects the function of the heart.
- If you suffer from a medical condition that increases your risk of heart disease.
How often you are tested after you are diagnosed with heart failure depends on several factors, including how low your initial Ejection Fraction is. If your Ejection Fraction continues to get worse, you may need to be tested more often. If it is stable, you may not need to be tested as often.
Is Ejection Fraction the only test for heart failure?
No. Ejection Fraction is just one of the parameters (measurements) your doctors use to assess your heart failure. Additional tests are needed to determine the exact cause of your heart failure and provide you with the right treatment.
These tests may include:
- Taking pictures of blood vessels (Angiography)
- Chest X-ray (`(Chest X-ray)`)
- Echocardiogram (also used to measure EF)
- Electrocardiogram (EKG)
- Exercise Stress Test (`(Exercise Stress Test)`)
Finally, things to remember
Ejection Fraction is an important indicator of the strength of the heart. It measures the amount of oxygen-rich blood pumped to the body with each heartbeat. A low Ejection Fraction is usually a sign of heart failure.
But don't worry! With proper medical treatment and lifestyle changes on your part, you can often get your Ejection Fraction back into the normal range. The most important thing is to follow your doctor's instructions carefully and pay attention to your symptoms.
If you have any further questions about this, don't hesitate to talk to your doctor. They are there to help you.
` Heart attack, ejection fraction, heart function, LVEF, heart health, shortness of breath, heart disease symptoms
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