Re: Ejection Fraction

Posted By CCF CARDIO MD-sc on October 13, 1997 at 15:14:02:

In Reply to: Ejection Fraction posted by VBB on October 06, 1997 at 13:52:37:







: 48 year old white male had heart attack on 11/23/96.
Presently on aspirin, magnesium oxide, metoprolol, altace, and zocor.
My ejection fraction is presently 41%. What is a good or "NORMAL" EF?
How bad is a 41% ejection fraction?












_______
Dear VBB
Your question is a very relevant question and I will try to give you some information which I hope you will find informative. Left ventricular ejection fraction or left ventricular emptying fraction is a means of quantifying left ventricular systolic function. There are different means of obtaining this value, description of which go beyond the scope of this discussion. The ejection fraction is ultimately obtained by dividing the end systolic by the end diastolic volumes and multiplying by 100 for a percentage.
There are certain conditions, specifically leaking valves on the left side of the heart, and left to right shunts ( eg VSD, coronary fistula )where the Ejection Fraction may be high but the actual forward flow which contributes to the actual cardiac output is lower. If measured correctly and if none of the confounding factors are present the Ejection Fraction is together with other variables has been shown to correlate with survival in patients with heart failure. Although in some way related the ejection fraction does not always correlate accurately with a patients symptoms which are effected by other biological conditions. The normal EF for somebody your age is 55-60%.  An EF of 41% would imply moderate or mild to moderate left ventricular dysfunction, this however may not have any relationship to the symptoms you may or may not be experiencing at this time. It looks like your doctors have you on an excellent medical regimen, which includes all the classes of drugs that improve prognosis and decrease complications post myocardial infarction so I have no suggestions on this regard. My only suggestion to you at this point, is that apart from being compliant with your  medications, you should make  sure that you are aggressively controlling any coronary risk factor you may have such as high blood pressure,  or raised cholesterol to minimize the risk of having any further heart damage. It might also be interesting for your doctors to recheck your ejection fraction by the same method it was checked in the past to see if your condition is stable or has changed in any way.  If you would like any further information or would like to see one of our cardiologists here at The Cleveland Clinic for this evaluation please feel free to call 1-800-CCF-CARE for an appointment.
Information provided in the Heart Forum is intended for general medical information only. Actual diagnosis and treatment of any particular medical condition can only be made your family physician(s).