Give Online: Help shape patient care for generations to come.
Cleveland Clinic Logo



Request an Appointment



Contact us with Questions

Expand Content

Ejection Fraction

Reviewed by Eileen Hsich, MD and Bruce Wilkoff, MD

What is Ejection Fraction and it's Link to Heart Failure?

What is ejection fraction?





How the Heart Works



What do the numbers mean?


A normal LVEF ranges from 55-70%. A LVEF of 65, for example, means that 65% of the total amount of blood in the left ventricle is pumped out with each heartbeat.


An EF of less than 40% may confirm a diagnosis of heart failure. Someone with diastolic failure can have a normal EF.



Ejection Fraction Measurement What it Means
55-70% Normal
40-55% Below Normal
Less than 40% May confirm diagnosis of heart failure

How is EF measured?

EF can be measured in your doctor’s office during tests such as:

  • Ultrasound of the heart (echocardiography) – used most often
  • Cardiac catheterization
  • Magnetic resonance imaging (MRI) scan of the heart
  • Nuclear medicine scan (multiple gated acquisition or MUGA) of the heart; also called a nuclear stress test
  • Computerized tomography (CT) scan of the heart

What is heart failure?

Heart failure means:

Why It’s Important to Know Your EF

If you have a heart condition, it is important for you and your doctor to know your EF.

Your EF can help your doctor determine the best course of treatment for you and the effectiveness of the therapies that have been prescribed.

You should have your EF measured initially when you are first diagnosed with a heart condition, and again as needed, based on changes in your condition. Ask your doctor how often you should have your EF checked.

  • The muscles of the heart are weaker than normal or the lower chambers of the heart are not able to relax and fill with blood as they normally do
  • Less blood is pumped out of the heart to organs and tissues in the body
  • Pressure in the heart increases

Heart failure does not mean that your heart has stopped working.

When the heart cannot pump enough oxygen and nutrients to meet the body’s needs, it tries to adapt. The chambers of the heart stretch to hold more blood to pump through the body with each heartbeat. Hormones are released into the bloodstream to increase the heart’s pumping power and increase blood flow into the heart chambers. These changes provide temporary relief, but over time, the heart muscle walls continue to weaken and/or stiffen.

There are two types of heart failure:

Systolic left ventricular dysfunction (or systolic heart failure) occurs when the left ventricle heart muscle doesn't contract with enough force, so less oxygen-rich blood is pumped throughout the body.

Heart failure with preserved left ventricular function (diastolic heart failure) occurs when the heart contracts normally, but the ventricles do not relax properly or are stiff and less blood enters the heart during normal filling. In this case, the ejection fraction may be normal.


Reviewed: 03/15



Schedule an Appointment

Toll-free 800.659.7822


© Copyright 2016 Cleveland Clinic. All rights reserved.