7 Ways to Improve Your Ejection Fraction (and What That Actually Means)

How to play the numbers game — and win
Running to improve the heart's ejection fraction

How’s your heart pumping today? Admittedly, most people probably don’t know that answer off the top of their head.

Advertising Policy

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

But knowing — and effectively managing — your ejection fraction can make a big impact on the quality of your life and health. Keeping tabs on it not only helps your doctor treat you more effectively but also leads to better outcomes.

Cardiologist J. Emanuel Finet, MD, says it straight: “Low ejection fraction is directly proportional to survival. By improving it, you improve your survival outlook.”

Dr. Finet does the math on ejection fraction and gives seven ways to help you improve your heart’s pumping power.

What is ejection fraction?

The heart has two main muscular chambers: the left and the right ventricle. Each chamber has MVP status in the body, working together to perform jobs you literally couldn’t live without:

  • Right ventricle: Pumps blood to the lungs to get oxygenated.
  • Left ventricle: Pumps oxygenated blood throughout your body.

A heart at rest holds a certain amount of blood. Ejection fraction refers to the percentage of that blood your heart pumps out with each beat. 

“Assuming a normal heart size and rate, when ejection fraction is normal, the heart is pumping a normal amount of blood,” Dr. Finet explains. “We can assume the blood is moving at a normal speed around the body.”

But a low ejection fraction spells trouble. “Low ejection fraction means the ventricle is not contracting sufficiently to pump enough blood out of the heart,” he says. “If the ejection fraction is abnormal, that person has some degree of heart failure.”

What’s normal ejection fraction?

Doctors calculate your ejection fraction using imaging techniques such as an echocardiogram. They measure the result in percentages. Here’s a breakdown of the numbers:

  • Normal ejection fraction (50% to 70%): Your heart is getting the job done!
  • Mildly below normal (41% to 49%): Though you may not have symptoms, your heart has started to struggle to pump enough oxygen-rich blood throughout the body.
  • Moderately below normal (30% to 40%): Patients experience heart failure with reduced left ventricular function symptoms. “The heart can’t supply the demands of the body because it can’t eject enough blood on every beat, so it increases in size and rate to compensate,” Dr. Finet explains.
  • Severely below normal (less than 30%): Patients with an ejection fraction this low frequently have significant symptoms due to the body’s inability to compensate for it. In addition, the risk of life-threatening heart rhythm disturbances is increased.

How to improve your ejection fraction

Taking care of your ticker not only helps heart failure symptoms, but it may even improve your ejection fraction and overall survival. Here are some ways to do that:

Advertising Policy

1. Partner up with a doctor

Whether it’s a cardiologist or your primary care physician, talk to a doctor about your symptoms. Doctors have many ways to help manage heart failure. From medications to implantable cardioverter defibrillators, their heart failure toolkit is chock-full of effective options to improve your heart health.

2. Be a heart detective

Put this on your doctor’s to-do list, too. By identifying and treating the underlying causes of low ejection fraction, you take major steps toward improving your quality of life. For example, if hypothyroidism is part of the puzzle, doctors can work on managing your thyroid levels. Similarly, your blood pressure or diabetes may need attention, as well as other modifiable conditions.

3. Get moving

Is there anything exercise can’t help? Physical activity, in particular aerobic exercises, can help your heart meet your body’s demands. It’s a classic case of doing more with less.

“If the heart weakens and provides the body with less oxygenated blood, the body suffers,” Dr. Finet notes. “But if we help the body use that oxygen more efficiently, we may improve your overall condition even if we are unable to change your heart function.” Talk to your doctor about joining a cardiac rehabilitation program or about where to start if you want to do it on your own.

4. Watch your weight

“Losing weight won’t necessarily improve ejection fraction, but it can make you feel better,” Dr. Finet says. Tracking your weight will also help you and your doctor determine whether fluid is being built up due to the abnormal heart function.

Advertising Policy

5. Go on a salt strike

Consuming too much sodium, or salt, can have a domino effect:

  • Diseased heart muscle, or cardiomyopathy, provides less blood to the kidneys.
  • The kidneys retain sodium and fluid to compensate for the low blood flow.
  • Sodium traps water, which abnormally accumulates on the heart and blood vessels.
  • Patients can become congested, or volume overloaded, because they have too much fluid that further impairs the functioning of the heart.
  • The excess fluid goes to the lungs, legs, liver and abdomen, causing the typical heart failure symptoms, such as shortness of breath, fatigue and swelling.

“So sodium for heart failure patients is like poison,” explains Dr. Finet, who recommends keeping salt consumption to no more than 1,500 to 2,000 milligrams per day. (A 1.5-ounce bag of potato chips is around 255 mg.)

6. Just say no

Eliminate substances that can cause more damage to your heart, such as alcohol, cocaine, amphetamines and cigarettes. These vices can tank your ejection fraction and worsen your symptoms.

7. Say goodbye to stress

Stress can raise your heart rate and blood pressure, which are heart failure no-nos. “Less stress can help patients improve their heart condition and help them feel better.”

Advertising Policy