With each heartbeat, the heart contracts and relaxes. Every contraction pushes blood out of the two pumping chambers (ventricles). When heart relaxes, the ventricles refill with blood. The ejection fraction (EF) refers to the amount, or percentage, of blood that is pumped (or ejected) out of the ventricles with each contraction. This percentage, or EF number, helps your health care provider determine if you have heart failure or other types of heart disease.
Typically, an echocardiogram is used to measure EF. Most often, the left ventricle, the heart’s main pumping chamber, is measured during an echocardiogram. A normal left ventricular ejection fraction (LVEF) is 55 to 75 percent.
According to the Heart Rhythm Society, the results of an echocardiogram mean:
It means that for a normal heart ejection fraction, your test reports must show it to be between 50 to 75 percent.
A low EF number is an early sign of heart failure. This is a condition where the heart does not pump enough blood to the rest of the body. With treatment, many people live well with heart failure. If you have a low EF number, it is important that you recognize the signs of heart failure, which may include:
A low EF can also cause a very rapid heartbeat, which can make your heart pump ineffectively. If you have heart disease, your doctor will check your EF periodically, closely monitoring your condition.
It is important to note that low ejection fractions caused by conditions such as heart failure or cardiomyopathy are rarely cured. Treatment is therefore focused on reducing symptoms and preventing the progress of the disease involved from worsening.
Certain strategies include lifestyle changes, medications and procedures, such as the insertion of an implantable defibrillator (ICD).
Certain medications help reduce the heart's workload, increase blood flow, widen vessels or eliminate excess water from the body, all which may help treating low ejection fraction. Prescribed medications may include:
Inotropes- Helps the heart to contract more vigorously and effectively, and helps to reduce symptoms.
Angiotensin II receptor blockers- Similar to ACE inhibitors, these medications reduce the stress on the heart muscle and may benefit patients with diabetes and heart disease. The medication apparently protects the kidneys from the diabetes-related complications.
Betablockers- These medications may improve symptoms by slowing the heart's contraction rate and reducing its pumping action, thus lessening the heart's workload.
Depending upon the cause of the depressed ejection fraction, certain procedures may be recommended, such as the insertion of one of the following:
Implantable Defibrillator (ICD) - This implanted device monitors for and, if necessary, corrects an abnormal heart rhythm by sending electrical charges to the heart. An ICD may benefit patients who have experienced serious episodes of fainting (syncope) or arrhythmias associated with a low ejection fraction. ICDs may also be built in to biventricular pacemakers.
This combined type of therapy may benefit heart failure patients who are also at high risk of sudden cardiac death due to some types of abnormal heart rhythms arrhythmias.
In select patients, biventricular pacemakers have appeared to improve ejection fraction and exercise tolerance.
Ventricular Assist Devices (VADs) - An implanted device that helps one of the heart's lower chambers (ventricles) to pump blood. These are used primarily as a "bridge to transplant," meaning that they help patients with low ejection fractions while they await a heart transplant.
So, for heart fraction improvement, if you have a heart condition causing low EF, a cardiac rehabilitation program with close follow up by cardiologist will be the best. If you are a healthy person, stay healthy by avoiding smoking, alcohol, healthy diet and with a program of aerobic and strength muscle exercise. Make exercise part of your daily routine.
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