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Ask the doctor: Can I have a low ejection fraction and not feel it?

Ask the doctor

Can I have a low ejection fraction and not feel it?

Q. My doctor told me that I have "low ejection fraction," but I feel fine. How can this be? I thought this was part of heart failure and would make someone feel bad. Should I do anything about it, even though I don't have any symptoms?

A. Your ejection fraction is the amount of blood your heart squeezes out with each beat. The typical heart fills with a half-cup of blood (four ounces) and ejects a bit over half that with each heartbeat. A normal ejection fraction is in the range of 55–70%.

A low ejection fraction is usually a sign that the heart is abnormally enlarged, thickened, or stiffened. Although it can cause problems such as shortness of breath, inability to exercise, swelling of the feet and lower legs, and fatigue or weakness, some people with a low ejection fraction feel fine.

As you mentioned, low ejection fraction is often a hallmark of heart failure. Taking an ACE inhibitor can help ward off this condition. A series of major clinical trials called the Studies of Left Ventricular Dysfunction (SOLVD) showed that this type of drug helped delay or prevent progression to heart failure in people with a low ejection fraction but no symptoms.

— Richard T. Lee, M.D. Associate Editor, Harvard Heart Letter

Last updated:	September 05, 2008