Our heart, a tireless muscle about the size of a fist, pumps blood continuously, 24 hours a day, 365 days a year. This vital organ is composed of four chambers: the powerful left and right ventricles, which pump blood, and the receiving chambers, the left and right atria. Valves strategically placed within the heart ensure blood flows in only one direction, preventing backflow. To keep the heart muscle healthy and functioning optimally, coronary arteries deliver a steady supply of blood, rich in nutrients.
A sophisticated electrical system orchestrates the rhythmic pumping of the heart. Disruptions to this system can lead to abnormal heart rhythms, including those that are too slow or too fast. While aging and heart attacks are common culprits, other factors can also contribute to these arrhythmias. Symptoms of irregular heart rhythms can range from uncomfortable palpitations to more serious consequences like fainting, weakness, and, in some cases, sudden cardiac death.
When coronary arteries become blocked, they restrict blood flow to the heart muscle. This can result in chest pain, known as angina, or even a heart attack. While lifestyle factors like a nutritious diet, regular physical activity, maintaining a healthy weight, managing cholesterol and blood pressure, and quitting smoking can significantly lower the risk of heart disease, genetic factors or other health conditions can predispose individuals to heart problems.
To accurately diagnose heart rhythm abnormalities, healthcare professionals utilize a range of diagnostic tools. These include 12-lead electrocardiograms (ECGs), Holter monitors, loop event recorders, and non-looping cardiac event monitors. If an arrhythmia is detected, a cardiac ablation procedure may be considered as a treatment option. During this procedure, specialized catheters are inserted into the heart, and radiofrequency energy is delivered through the catheter tip to target and destroy the specific heart tissue responsible for the arrhythmia.
Ejection Fraction
The heart's pumping action involves a rhythmic cycle of contraction and relaxation. During contraction, blood is forcefully ejected from the ventricles. When the heart relaxes, the ventricles refill with blood. Ejection fraction (EF) is a crucial measure of heart function, representing the percentage of blood pumped out of the ventricles with each contraction. A low EF can be a sign of heart failure or other heart-related issues, providing valuable insights for healthcare providers in assessing heart health. A healthy heart typically pumps out just over half its volume of blood with each beat. A normal ejection fraction (EF) falls within the range of 50 to 75 percent.
Measuring Ejection Fraction
Ejection fraction (EF) is typically measured through a painless, non-invasive test called an echocardiogram. This ultrasound-based test creates a video image of the heart, allowing healthcare providers to assess the heart's structure, function, and pumping ability.
While echocardiograms primarily measure the left ventricle's function, other tests like magnetic resonance imaging (MRI), cardiac catheterization, nuclear medicine scans, and computed tomography (CT) can also be used to assess EF.
Ejection Fraction Ranges and Their Implications:
- 50-75%: Normal heart function
- 36-49%: Below-normal heart function
- 35% and below: Low heart function, indicating potential heart failure
A Low Ejection Fraction
A low ejection fraction (EF) is often an early sign of heart failure, a condition where the heart struggles to pump enough blood to the body. While heart failure can be a serious condition, many people with this condition can live well with proper treatment.
If you have a low EF, it's important to be aware of the signs and symptoms of heart failure, which may include:
- Swelling in the feet
- Fatigue (feeling tired all the time)
- Shortness of breath
A low EF can also increase the risk of irregular heartbeats, which in some cases can lead to sudden cardiac arrest.
If you have heart disease, your cardiologist will regularly monitor your EF to assess your heart's health and adjust your treatment plan as needed.
Improving Your Ejection Fraction
To improve your heart's pumping function, your cardiologist may recommend lifestyle modifications and medications:
Dietary Changes:
- Reduce Salt Intake: Limiting sodium intake to 2,000 milligrams per day is crucial. A low EF can impair kidney function, leading to fluid retention. Reducing salt intake helps prevent further fluid buildup and strain on the heart.
Fluid Management:
- Monitor Fluid Intake: A low EF can cause fluid buildup in the lungs and other tissues. Your cardiologist will recommend a specific fluid intake limit to manage this issue.
Regular Exercise:
- Incorporate Physical Activity: Regular exercise, such as brisk walking, can strengthen the heart and improve its pumping ability. Consult with your cardiologist to develop a suitable exercise plan.
Medication:
Your doctor may prescribe medications to help improve your heart's function and manage symptoms. These medications may include:
- Diuretics: To help remove excess fluid from the body
- ACE inhibitors or ARBs: To relax blood vessels and reduce the workload on the heart
- Beta-blockers: To slow the heart rate and reduce the force of contractions
- Digitalis: To strengthen heart contractions
It's important to work closely with your healthcare provider to develop a personalized treatment plan that addresses your specific needs and 1 improves your heart health.
Questions to ask your cardiologist?
- When is the next recommended check-up for my EF?
- Should I be worried about my current EF level?
- Would it be beneficial to consult with a heart rhythm specialist?
- Are there any additional tests or treatments you recommend?
- What other monitoring strategies can be implemented to track my heart health?
- What specific actions can I take to improve my EF?
- How frequently should my EF be reassessed?