Understanding Ejection Fraction — What It Reveals About Your Heart

When you think of heart health, you probably consider cholesterol, blood pressure, or ECG readings. But there’s one powerful indicator that often goes unnoticed: Ejection Fraction, or EF. If you or a loved one has ever undergone an ECHO test, this number likely appeared in your report — and it can tell you more about your heart’s performance than you think.

So what is Ejection Fraction, and why should every Indian adult understand it?

What Is Ejection Fraction?

Ejection Fraction is the percentage of blood your heart pumps out with each beat.

Your heart has four chambers, and the left ventricle — the main pumping chamber — pushes oxygen-rich blood to the rest of the body. EF tells us how effectively this ventricle is doing its job.

For example, if your EF is 60%, it means 60% of the blood in the ventricle is pumped out with each heartbeat. A healthy EF indicates that your heart is functioning properly. A lower or higher than normal EF can signal problems.

What’s a Normal Ejection Fraction?

Here’s a general guide:

• 55% to 70% — Normal
  
• 40% to 54% — Slightly below normal; may indicate mild weakness
  
• 35% to 40% — Borderline; may suggest heart failure
  
• Below 35% — High risk; could mean moderate to severe heart failure
  
• Above 75% — May indicate hypertrophic or restrictive cardiomyopathy (too forceful or inefficient contractions)
  

Many people with low EF may not experience obvious symptoms at first. That’s why EF is considered a critical early warning for hidden heart dysfunction.

How Is EF Measured?

The most common test to measure EF is an Echocardiogram (ECHO), which uses ultrasound waves to create live images of the heart in motion. It’s non-invasive, painless, and provides detailed information on heart structure and function.

Other methods include:

• Cardiac MRI
  
• Nuclear medicine scans
  
• Cardiac catheterization (for more complex cases)
  

Among these, ECHO is the most accessible and widely recommended screening tool in India.

Why Ejection Fraction Matters

Low EF may be a sign of:

• Coronary artery disease
  
• Cardiomyopathy (weakened heart muscle)
  
• Uncontrolled high blood pressure
  
• Post-heart attack damage
  
• Chronic alcohol use or infections
  

A person with a very low EF may feel breathless, extremely tired, or dizzy — but many live with asymptomatic low EF for months or even years, until a major cardiac event occurs.

Monitoring EF helps cardiologists:

• Assess the severity of heart failure
  
• Decide on treatment options (medication, lifestyle changes, surgery, etc.)
  
• Track progress over time
  

When Should You Get Your EF Checked?

You should ask for an EF evaluation if you:

• Have a family history of heart disease
  
• Are diabetic or hypertensive
  
• Experience shortness of breath or swelling in legs
  
• Feel excessive fatigue without obvious reason
  
• Had COVID-19 or viral illness affecting stamina
  
• Are recovering from a heart attack or cardiac surgery
  

Even without major symptoms, adults above 35 should consider an annual heart screening that includes an ECHO test.

What If My EF Is Low?

Don’t panic. With timely care, low EF can be managed and even improved. Treatment may include medications, dietary changes, controlled physical activity, and close medical supervision.

More importantly, early detection can prevent life-threatening complications.

The Bottom Line

Ejection Fraction isn’t just a number — it’s a window into how well your heart is working. While cholesterol and sugar often get the spotlight, EF quietly tells the story of your heart’s strength, beat by beat.

At Heartbeat Foundation, we believe awareness saves lives. Ask about your EF. Understand it. Monitor it.

Because what you don’t see is often what matters most.