To understand ejection fraction (EF), you first need to understand how your heart pumps blood. Most people think the heart pumps out all the blood that comes into it. Yet, in reality, it’s more like a bucket used to bail out a boat. Each time you use the bucket to toss water over the side of the boat, some water is left in the bucket. The same thing happens with our blood, each time our heart pumps blood out some is left behind.
Ejection fraction is the measure of how much blood is pumped out through your left ventricle each time your heart contracts. A higher ejection fraction means more blood is being pumped out (and less is left behind)—so your heart’s working efficiently and your cells are getting the oxygen-rich blood they need.
What is Normal Ejection Fraction for the Heart?
Heart ejection fraction is measured at the point where your left ventricle pumps blood out to your aorta. It can be calculated non-invasively with an echocardiogram or more directly during an angiogram of the heart. A noninvasive MUGA scan of the heart will also estimate the heart ejection fraction.
What your ejection fraction numbers mean:
- Normal Ejection Fraction: 50%-70%. People in this range generally feel great (from a cardiac standpoint anyway).
- Low Ejection Fraction: 35%-45%. Those in this range may, or may not, have symptoms. One noticeable symptom is difficulty keeping up with the oxygen demand for physical activity.
- Weak Ejection Fraction: Below 35%. People in this range have heart failure. Those awaiting heart transplants have an even lower ejection fraction, often just 10-15%, and it’s all they can do to sustain simple activity such as getting from a bed to a chair.
People with extremely low ejection fraction can suffer from blood backing up into the lungs, creating the breathing difficulties commonly experienced in someone with congestive heart failure.
Symptoms of Low Ejection Fraction
While ejection fraction can have no symptoms at all, especially if it’s only slightly low, symptoms of low ejection fraction can include:
- Shortness of breath
- Weakness in your legs
- Rapid or irregular heartbeat
What Are the Causes of Low Ejection Fraction?
There are numerous conditions that can lead to low ejection fraction, including:
- Cardiomyopathy (thickening of the heart tissue)
- Coronary artery disease
- Heart attack
- Long-standing high blood pressure levels
- Valvular issues
- Infections of the heart muscles
Treating Low Ejection Fraction
Treatments for low ejection fraction will depend on how low your ejection fraction is, the cause of your low ejection fraction, and your overall health. So, you want to work very closely with your doctor to treat it.
In my practice, I found that with patients who had an ejection fraction of 30-35%, walking was an effective form of exercise. Yet, make sure you’re cleared by your doctor before you begin a new exercise program. Your doctor may also recommend a cardiac rehab program where you exercise in a monitored setting.
On the supplement front, I encourage people with low ejection fractions (with or without heart failure) to take nutrients that help to build up your heart energy reserves, including:
- Coenzyme Q10: 100mg, 3 times daily with meals
- D-Ribose: one scoop 2-3 times daily
- L-Carnitine: 1 g, 2-3 times daily on an empty stomach
- Broad-spectrum magnesium: 100 mg, 2-3 times a day
Remember to coordinate closely with your doctor before adding nutrients to your routine.