What should I do if my ejection fraction is reduced?

A patient Mr. Lu asked for advice. He has had more symptoms of coronary heart disease recently. He did a cardiac ultrasound and found that his ejection fraction was 39%, while it was 40% to 50% before. What is the connection between them?

A: Color Doppler ultrasound is a very important examination, especially for examining the heart. It not only dynamically displays the heart’s structure but also its contractile function. Regarding cardiac contractile function, a key evaluation indicator is the ejection fraction, which is often expressed in examination reports as EF or LVEF .

What is ejection fraction?

In medical terms, ejection fraction is the percentage of stroke volume to ventricular end-diastolic volume. Simply put, it assesses the heart’s ability to pump blood throughout the body during contraction and reflects the systolic function of the left ventricle, the most important part of the heart.

For example, if there are 100 milliliters of blood in the ventricle, under normal circumstances, at least 50 milliliters must be pumped out to meet the body’s needs. Otherwise, ischemia and hypoxia will occur. The normal range of ejection fraction in healthy adults is 50% to 70%. If it is 40% to 50%, it is mildly reduced, 30% to 40% is moderately reduced, and <30% is severely reduced.

Does low ejection fraction mean heart failure ?

A low ejection fraction usually indicates decreased cardiac contractility and may indicate heart failure. However, determining whether the condition is heart failure depends on whether the patient has underlying medical conditions, such as coronary artery disease or hypertension, and whether they have clinical symptoms. Symptoms such as significant chest tightness, shortness of breath, and difficulty breathing after activity suggest heart failure. A low ejection fraction (<40%) is also often a sign of heart failure. Generally speaking, the lower the ejection fraction, the worse the heart function.

Of course, the higher the ejection fraction is, the better it is. In clinical practice, there is a type of patient whose with it is not low, but who also has symptoms of heart failure such as wheezing, fatigue, leg edema, and nighttime shortness of breath. They are called heart failure patients with preserved ejection fraction (LVEF ≥ 50%), which is also a type of heart failure.

Can low ejection fraction be restored to normal?

If you discover a low ejection fraction, you should still see a cardiologist promptly . If diagnosed with heart failure, you should actively seek treatment under the guidance of a doctor. It’s important to note that, like diabetes and hypertension, chronic heart failure is a chronic disease that requires ongoing comprehensive treatment and rehabilitation, primarily including the following points.

(1) Correct the cause:

There are many causes of low ejection fraction, and one of the most important principles of treatment is to treat the cause. For example, coronary artery disease, hypertension, diabetes, hyperthyroidism, and valvular heart disease can all lead to myocardial damage. Once the cause is eliminated, cardiac function can significantly improve or even return to normal. During treatment, medications should be taken regularly, and no medications should be discontinued or changed without authorization. Regular checkups are essential.

(2) Dietary adjustment:

Avoid overeating. Eat small, frequent meals, and keep food soft and easy to digest. Maintain a low-salt, low-fat, and low-sugar diet, limiting daily salt intake to 2-3 grams. Avoid the intake of sauces and pickled foods. Must avoid sugary drinks, overly sweet desserts, and fruits. Avoid eating fatty meats and animal offal, which are high in cholesterol. Eat more fresh fruits and vegetables, nuts, fish and poultry, whole grains, sweet potatoes, soy products, and skim milk, which are rich in dietary fiber and vitamins. Strictly control fluid intake: adults should consume 1000-1500 ml per day, including both food intake and fluids.

(3) Lifestyle adjustment:

Correct some bad lifestyle habits. Avoid overexertion and staying up late, and ensure adequate sleep. It’s essential to quit smoking and drinking. Smoking is a major threat to cardiovascular health, and drinking not only increases the burden on the heart but can also directly damage the myocardium. Moderate exercise is beneficial for the heart, but it’s best to do it under a doctor’s supervision. If you’re in the acute phase of illness, exercise should be strictly limited. Your condition is stable, you can opt for brisk walking, jogging, or Tai Chi as directed by your doctor. If you feel any discomfort during exercise, stop immediately.

(4) Good attitude:

When we’re angry, our blood vessels dilate and our heart speeds up, increasing the heart’s workload. This is due to abnormal hormone secretions caused by emotion. Heart failure patients should learn more about heart failure and avoid ignoring or overemphasizing it, striving to peacefully coexist with it. They should avoid negative emotions like anger and depression, and instead relieve stress by listening to soft music, chatting with friends, and reading.