What Is Ejection Fraction? Types and Normal Ranges

If you’ve ever had an echocardiogram or been evaluated for heart disease, chances are you’ve heard your doctor mention ejection fraction, often shortened to EF. It’s one of the most important numbers in cardiology, yet also one of the most confusing for patients.

Patients often want clear answers to common questions about the ejection fraction of the heart, what it measures, what range is considered normal, and what it means if the value is lower than expected. Having a solid understanding of the ejection fraction of the heart can make test results easier to interpret and support more informed decisions about your heart health.

What Is Ejection Fraction?

Ejection fraction (EF) is the percentage of blood that the heart pumps out of the left ventricle with each heartbeat. The left ventricle is the heart’s main pumping chamber, responsible for delivering oxygen-rich blood to the rest of the body.

Doctors often refer to this as left ventricular ejection fraction (LVEF). An echocardiogram, one of the most commonly performed tests at Cardiology Care NYC, is the primary way LVEF is measured.

A simple way to picture it:

The left ventricle fills with blood
The heart squeezes
Ejection fraction tells us how much blood leaves the ventricle with each squeeze

For example, if the ventricle fills with 100 milliliters of blood and pumps out 60 milliliters, the heart ejection fraction is 60%.

Why Ejection Fraction Matters

Your cardiac ejection fraction is a key indicator of how strong and efficient your heart is. Cardiologists use it to:

Diagnose and classify heart failure
Monitor heart function over time
Guide medication and device therapy
Estimate prognosis and risk

Cardiologists use ejection fraction as a cornerstone of heart failure evaluation and management. At Cardiology Care NYC, this measurement is routinely used to diagnose heart conditions, guide treatment decisions, and monitor heart health over time using evidence-based cardiology standards.

Normal Ejection Fraction Ranges

Understanding the ejection fraction normal range helps put test results into perspective.

Ejection Fraction Range

Ejection Fraction	Meaning
50–70%	Normal ejection fraction
41–49%	Borderline or mildly reduced
≤ 40%	Reduced ejection fraction
< 30–35%	Severely reduced

A normal ejection fraction means the heart is pumping efficiently. A low ejection fraction suggests weakened heart muscle or prior heart damage.

Normal Ejection Fraction by Age

Patients often ask about a normal ejection fraction by age chart, often as part of a broader heart health screening to better understand overall cardiovascular risk. The reassuring news is that EF remains relatively stable across adulthood.

Normal Ejection Fraction Range by Age

Age Group	Typical EF Range
Young adults	55–70%
Middle-aged adults	55–70%
Older adults	50–70%

While aging can affect how the heart relaxes, a low EF is not considered a normal part of aging. The ejection fraction normal range by age stays fairly narrow.

Types of Heart Failure Based on Ejection Fraction

Heart failure is classified by EF because different types of heart failure respond to different treatments.

Heart Failure With Reduced Ejection Fraction (HFrEF)

Ejection fraction < 40%
Also called reduced ejection fraction

Common causes include:

Symptoms often include shortness of breath, fatigue, swelling, and reduced exercise tolerance. Additional testing such as an electrocardiogram (ECG) or holter monitoring may be used to assess rhythm abnormalities associated with reduced ejection fraction. This form of heart failure with reduced ejection fraction has well-established, evidence-based treatments that can improve survival and quality of life.

Heart Failure With Preserved Ejection Fraction (HFpEF)

Ejection fraction ≥ 50%
Also called preserved ejection fraction

In heart failure with preserved ejection fraction, the heart squeezes normally but is stiff and doesn’t fill properly.

Common contributors include:

Long-standing high blood pressure
Diabetes
Obesity
Aging
Atrial fibrillation

Patients with heart failure preserved ejection fraction may experience symptoms similar to those with reduced EF, even though the number appears normal.

What Is a Dangerously Low Ejection Fraction?

So, what is considered a dangerously low ejection fraction?

In general:

EF below 35% is considered high risk

At this level, the risk of dangerous heart rhythms, hospitalization, and sudden cardiac death increases. Cardiologists may recommend advanced therapies such as implantable defibrillators or cardiac resynchronization therapy when appropriate.

Symptoms of Low Ejection Fraction

Common symptoms of low ejection fraction include:

Shortness of breath with activity or when lying flat
Persistent fatigue
Swelling in the legs, ankles, or abdomen
Rapid weight gain from fluid retention
Reduced ability to exercise
Nighttime coughing or wheezing

Symptoms can vary from person to person, which is why clinical evaluation is just as important as the EF number itself.

Ejection Fraction and Heart Failure Stages

Ejection fraction helps guide heart failure staging, but it is only one part of the overall assessment. Doctors also consider:

Symptom severity
Functional capacity
Response to treatment
Hospitalization history

Understanding the ejection fraction heart failure stages allows for more personalized and effective care.

How Is Ejection Fraction Measured?

Ejection fraction is measured using cardiac imaging tests such as:

Echocardiogram (most common)
Cardiac MRI
Nuclear stress test (MUGA scan)
Cardiac catheterization (less common today)

Your cardiologist will recommend the most appropriate test based on your symptoms, medical history, and overall heart health. At Cardiology Care NYC, testing may include an echocardiogram, stress testing, or nuclear cardiology to fully evaluate heart function.

How to Improve or Increase Ejection Fraction

A common and hopeful question is how to improve ejection fraction. In many cases, EF can improve with proper treatment.

Evidence-Based Strategies

Medications

ACE inhibitors, ARBs, or ARNIs
Beta-blockers
Mineralocorticoid receptor antagonists
SGLT2 inhibitors

Lifestyle changes

Heart-healthy, low-sodium diet
Regular, guided physical activity
Weight management
Avoiding tobacco and excessive alcohol

Treating underlying conditions

Controlling blood pressure
Managing diabetes
Treating coronary artery disease and sleep apnea

Devices (when indicated)

Implantable cardioverter-defibrillators (ICDs)
Cardiac resynchronization therapy (CRT)

These approaches answer both how to increase ejection fraction and how to protect long-term heart health.

What Is a Good Ejection Fraction?

For most adults, a value between 50% and 70% is considered healthy. However, numbers don’t tell the full story. Symptoms, activity level, and overall heart function matter just as much as the EF itself.

When To See A Doctor

You should seek medical evaluation if you experience these symptoms or have abnormal screening results. A comprehensive cardiology consultation can help determine whether further cardiac testing or treatment is needed.

You should seek medical evaluation if you experience:

New or worsening shortness of breath
Swelling or unexplained fatigue
Reduced exercise tolerance
Known heart disease with declining EF
Abnormal cardiac imaging results

Early evaluation leads to better outcomes and more treatment options. A timely consultation at Cardiology Care NYC, often combined with advanced cardiac screening or cardiovascular screening, can help identify heart problems early and create a personalized plan to protect your long-term heart health.

Conclusion

Ejection fraction is a powerful and widely used measure of heart function, but it is only one piece of the puzzle. Whether your EF is normal, preserved, or reduced, timely diagnosis, proper treatment, and heart-healthy habits can make a meaningful difference.

Many people live full, active lives with managed ejection fraction levels. Ongoing follow-up with a cardiology specialist and a personalized care plan, such as those provided at Cardiology Care NYC, is key to protecting your heart for the long term.

Frequently Asked Questions

Can ejection fraction change from day to day?

Minor fluctuations can occur due to heart rate, blood pressure, or testing conditions. Significant changes usually reflect a true change in heart function and should be reviewed by a cardiologist.

Is it possible to have heart symptoms even with a normal ejection fraction?

Yes. Symptoms can occur due to problems with heart relaxation, valve disease, or non-cardiac conditions, even when EF is normal.

Does a higher ejection fraction always mean a healthier heart?

No. A very high EF may occur when the heart muscle is stiff or under stress. EF must be interpreted along with symptoms and imaging findings.

How often should the ejection fraction be rechecked?

It depends on your condition. Stable patients may need infrequent testing, while those with heart failure or new symptoms may require regular reassessment.

Can stress or anxiety affect ejection fraction results?

Stress does not directly lower EF but can influence heart rate and blood pressure, which may slightly affect measurements.

Source

Cleveland Clinic – What is ejection fraction?
American Heart Association – Ejection Fraction Heart Failure Measurement
Health Line – Everything You Need to Know About Ejection Fraction
Harvard Health Publishing – Can I improve my ejection fraction?

Disclaimer

This blog is for informational & educational purposes only and does not intend to substitute any professional medical advice or consultation. For any health-related concerns, please consult with your physician, or call 911.