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How the Normal Heart Works Part II of III

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The Normal Heart Part II of III

Ejection Fraction:


With each heartbeat, the heart contracts and relaxes.  Every contraction pushes blood out of both ventricles.   When the heart relaxes, both ventricles refill with blood.   Ejection fraction (EF) equals the amount, or percentage, of blood that is pumped (or ejected) with each contraction from the ventricles.   This percentage, or EF number, helps your physician determine if you have heart failure or other types of heart disease.



Ejection Fraction

A normal heart pumps just over half the heart’s volume of blood with each beat.   Therefore a normal EF is between 50 to 75 percent.


Measuring EF


Typically, EF is measured by a painless, non-invasive, simple test called an echocardiogram.   An ultrasound imaging machine uses sound waves to create a videotaped image of the heart, showing valves and movements, the four chambers and how well the heart is pumping.


Most often, an echocardiogram measures the left ventricle, the heart’s main pumping chamber.   Other tests used to measure EF include magnetic resonance imaging (MRI), cardiac catheterization, nuclear medicine scans, and computed tomography (CT).


Ejection Fraction Numbers:  
50-75% The heart’s pumping ability is Normal
36-49% The heart’s pumping ability is Below Normal
35% and Below The heart’s pumping ability is Low




A Low EF


A low EF number is an early indicator of heart failure. This is where the heart does not pump enough blood to the body. Luckily, with treatment, many people live well with heart failure.   If you have a low EF number, it’s important that you recognize the signs of heart failure:


  • Swelling in the feet
  • Fatigue (feeling tired all the time)
  • Shortness of breath


A low EF can also cause irregular heartbeats, which can make your heart stop pumping suddenly.   If you have heart disease, your cardiologist will check your EF, closely monitoring your condition.




Depending on your EF number, your cardiologist may recommendation medications or other things to improve how well your heart pumps such as:


  • Reduce Salt Intake – Limiting salt (sodium) to just 2,000 mg a day is an important part of maintaining a healthy heart and treating heart failure.   Your kidneys get less blood than they should with a low EF.   This makes the kidneys unable to rid the body of excess salt and water.   Further excessive salt intake can lead to even more fluid retention.   Also, excess salt increases your blood pressure.  This makes an already weak heart work much harder.


  • Manage Your Fluids – With a low EF, blood backs up in your lungs and forces fluid into the breathing spaces.   The fluid accumulates, making it hard to breathe.   Excess fluid also causes weight gain and swelling.   Your cardiologist will recommend the amount of fluids you should have daily, depending on the severity of the EF.


  • Exercise Regularly – Exercise helps strengthen your heart and improves how well it pumps blood to the rest of the body.   It only takes 30 minutes a day of activity, walking is included.   Talk to your cardiologist about an exercise program that is right for you.




  • When should my EF be checked next?
  • Should I be concerned with how low the EF number is?
  • Do I need to see a specialist specializes in heart rhythm?
  • Do I need additional treatments or tests?
  • What else can be done to monitor my heart health?
  • What else should do about my EF?
  • How often do I need to have my EF rechecked?
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