Knowing Your Ejection Fraction

Ejection fraction (EF) percentage is an important number for people with heart failure to know. It is a sign of how well your heart is pumping out (ejecting) blood.

Heart failure is a lasting health problem that needs to be treated. Your EF percentage is used to help choose treatment and find out how well it is working.

Testing Your EF

An echocardiogram is the most common test used to measure EF. It uses ultrasound to test how well the heart’s valves and muscle are working. It can also show how much blood is in your heart.

Other tests that may be used are:

  • MUGA scan—a nuclear imaging scan
  • CAT scan—an X-ray image made with computers
  • Cardiac catheterization—a procedure that places a tube into a blood vessel that leads to your heart to view it
  • Nuclear stress test—a test that uses a radioactive dye and imaging machine to view blood flow to your heart

EF Values

Your heart fills with blood before it beats and pushes blood out to the body. Some blood will be pushed out to the body, some blood will stay in the heart. EF is a measure of how much blood was pushed out of the left side of the heart. EF describes how well your heart is pumping blood out to the rest of your body:

  • Normal EF —heart pumps out 50% to 70% of the blood in the heart
  • Boderline EF —heart pumps out 41%-49% of the blood in the heart
  • Reduced EF —heart pumps less than 40% of the blood in the heart

Low EF levels will cause shortness of breath and fatigue. It will also reduce blood flow to vital organs like brain, kidney, or lungs. If you have lower than normal levels you may be diagnosed with heart failure reduced ejection fraction (HFrEF).

Your care team will track EF levels to:

  • Look for changes in your health status
  • Track progress of treatment
  • Follow recovery from exacerbation

Preserved Ejection Fraction

Some people with heart failure may have a normal EF. This is called heart failure with preserved ejection fraction (HFpEF). The level of blood that passes out of the heart is still too low to support the body. EF is normal because the amount of blood that starts in the heart is lower than normal. This makes the percentage of blood that leaves the heart look normal. A thickened heart wall decreases the space to hold blood. Less blood is available to be pumped out.

Stay in Touch with Your Care Team

If you are having trouble handling heart failure, tell your care team right away. Some ejection fraction may be improved with treatment. Changes in EF may also need a change in the treatment plan and focus.


American Heart Association
Centers for Disease Control and Prevention


Heart and Stroke Foundation of Canada


Ejection fraction heart failure measurement. American Heart Association website. Available at: Updated May 31, 2017. Accessed May 6, 2019.
Heart failure with preserved ejection fraction. EBSCO DynaMed website. Available at: Updated November 19, 2018. Accessed May 6, 2019.
Heart failure with reduced ejection fraction. EBSCO DynaMed website. Available at: Updated April 16, 2019. Accessed May 6, 2019.
Last reviewed May 2019 by EBSCO Medical Review Board Peter Oettgen, MD
Last Updated: 10/16/2019

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