Ejection Fraction

Definition

Ejection Fraction (EF) is the percentage of blood volume in the left ventricle that is pumped out with each contraction. It is the gold-standard measurement of systolic heart function and is measured by echocardiogram, MUGA scan, or cardiac MRI.

Normal and Abnormal Ranges

• Normal: 55 to 70%
• Mildly reduced: 41 to 54% (HFmrEF)
• Reduced (HFrEF): ≤ 40%
• Preserved (HFpEF): ≥ 50% with HF symptoms

Clinical Implications

Low EF indicates systolic dysfunction and correlates with heart failure severity, arrhythmia risk, and mortality. ICD is indicated for EF ≤ 35% after optimal medical therapy. Heart transplant is considered in severe cases.

Nursing Considerations

Teach patients with reduced EF about salt and fluid restriction, daily weights, medication adherence (beta-blockers, ACE/ARB/ARNI, aldosterone antagonists, SGLT2 inhibitors), and symptom monitoring. Exercise rehabilitation improves function.

NCLEX Relevance

Normal EF 55 to 70%. EF ≤ 40% = systolic heart failure.