Left ventricular ejection fraction of the heart of the norm causes lowering and high how to increase

Today, in the age of technology, the development of cardiovascular diseases causes quite serious concerns not only among employees of medical organizations, but also in the upper levels of government. That is why, more and more, new strategies are being developed to reduce the diseases under consideration, and scientific developments are being actively funded that will help achieve these goals in the future.

One of the directions in the treatment of patients with cardiovascular diseases is the prevention and treatment of cardiac pathology. If in this area some of the diseases can be successfully treated, others still remain “difficult to cure” due to the lack of methods and other necessary components of proper treatment. This article discusses the concepts of cardiac output, its norms and methods of treatment, the fraction of cardiac output (normal in children and adults).

The concept of “ejection fraction” is of interest not only to specialists. Anyone who is being examined or treated for heart and vascular disease can be confronted with a concept such as ejection fraction. Most often, the patient hears this term for the first time, undergoing an ultrasound examination of the heart – dynamic ultrasound imaging or radiopaque examination.

In Russia, a daily imaging examination is required for thousands of people. More often, an ultrasound examination of the heart muscle is performed. It is after such an examination that the patient raises the question: ejection fraction – what is the norm? You can get the most accurate information from your doctor. In this article, we will also try to give an answer to this question.

A healthy heart, even at rest with each beat, throws more than half of the blood from the left ventricle into the vessels. If this indicator is much lower, then we are talking about heart failure. Myocardial ischemia, cardiomyopathy, heart defects and other diseases can lead to this condition. So, the norm of the ejection fraction of the left ventricle is 55-70%.

Not only adults, but also children have to undergo such a procedure as an ultrasound examination of the heart. Very often, in addition to the conclusion, parents are interested in all the normal indicators in the work of the heart of their child. We will talk about the norms of ultrasound of the heart together.

Performance indicators of the cardiovascular system in newborns All normal ultrasound parameters of the heart depend on the body weight of the child. There is a border when children with a weight of up to 3,5 kilograms have one norm, and for children with a body weight of up to 4,5 kilograms these indicators are different. Here is a table that contains some indicators of the cardiovascular system in newborns.

There is a calculation formula. To do this, the stroke volume is multiplied by the heart rate. So get the right amount. The result will indicate how much volume is pushed in one minute. In general, the normal rate should reach approximately 5,5 liters.

In medicine, they also use special programs that automatically calculate the fraction. For this, the Teicholz formula, the Simpson method, is used. Moreover, the data for these two calculations can differ by an average of 10%. The PV should be in the range of 50-60%, the Simpson norm suggests that the lower limit should not be less than 45%, and according to Teicholz 55%.

The Teicholz formula uses indicators of systolic and diastolic volume and size of the left ventricle. A small part of the latter is involved in the study; the total length indicator does not matter at the same time. Usually, the study is carried out on old equipment and in the presence of areas with impaired local contractility (for example, in the case of ischemia), the Teicholz formula can give a fuzzy and fuzzy result.

To get the PV index, the shortening volume is multiplied by a factor of 1,7. The OS is obtained from the formula ((KDD – KSD) / KDD) * 100%. Where KDD is the final diastolic diameter, KSD is the final systolic diameter. Simpson’s formula is more modern, all significant myocardial zones are shown here taking into account the geometry of the ventricle and the presence of zones with impaired local contractility through the apical 4 and 2-chamber section.

Simpson’s method assumes the division of the cavity of the left ventricle into thin discs and the determination of their boundaries. The outlined systole and diastole are visible along the contour of the cardinal surface of the ventricle; according to these data, an estimate of the ejection volume can be made.

The indicators do not depend on the gender of the patient, therefore, in women and men, the norms are identical. However, they may vary by age. The older the person, the lower their norm. Less than 45% of EF is considered. With indicators in the region of 40%, heart failure can be suspected. If in adults the level is less than 35%, then this indicates that violations occur and the person is in danger.

At a younger age, the rate may be higher. So, the norm in children from birth to 14 years is in the range of 60-80%. Nevertheless, it is impossible to consider only one PV, when making a diagnosis, all indicators of the heart work are taken into account. The table of norms involves comparing the indicators of growth, weight, fraction and heart rate.

If the doctor has a suspicion of a malfunction of the heart, he directs the patient to make a cardiogram and a biochemical blood test. Holter monitoring, electrocardiogram, bicycle ergometry and ultrasound of the organ can also be performed. The indicator can be calculated with radiopaque or isotropic ventriculography, as well as with ultrasound of the heart.

  • Cardiac output should be between 55 and 60%.
  • The magnitude of the right-chamber atrium is 2,7-4,6 cm.
  • The diameter of the aorta is 2,1-4,2 cm.
  • The size of the left atrium is 1,8-4 cm.
  • The norm of the stroke volume is 60-100 cm.

This indicator can be calculated by the formula of Teicholz or Simpson. The calculation is carried out using a program that automatically calculates the result depending on the final systolic and diastolic volume of the left ventricle, as well as its size. Simpson’s calculation is considered more successful, since according to Teicholz small sections may not fall into the section of the study with two-dimensional Echo-CG myocardium with impaired local contractility, while with the Simpson method more significant sections of the myocardium fall into the circumference.

The normal value of the ejection fraction differs in different people, and also depends on the equipment on which the study is conducted, and on the method by which the fraction is calculated.

The average values ​​are approximately 50-60%, the lower limit of the norm according to the Simpson formula is at least 45%, according to the Teicholz formula – not less than 55%. This percentage means that it is precisely this amount of blood for one heart beat that must be pushed through the heart into the lumen of the aorta in order to ensure adequate oxygen delivery to the internal organs.

35-40% speak of advanced heart failure, even lower values ​​are fraught with fleeting consequences. In children in the neonatal period, EF is at least 60%, mainly 60-80%, gradually reaching the usual normal values ​​as they grow. From deviations from the norm more often than an increased ejection fraction, a decrease in its value occurs due to various diseases.

If the indicator is lowered, it means that the heart muscle cannot contract sufficiently enough, as a result of which the volume of expelled blood decreases, and the internal organs, and, first of all, the brain, receive less oxygen. Sometimes, in the conclusion of echocardioscopy, you can see that the PV value is higher than the average indicators (60% or more).

As a rule, in such cases, the indicator is no more than 80%, since the left ventricle cannot be expelled into the aorta due to physiological characteristics. As a rule, high PV is observed in healthy individuals in the absence of any other cardiological pathology, as well as in athletes with trained heart muscle, when the heart contracts with each beat with a greater force than an ordinary person, and expels a larger percentage of the blood contained in it into the aorta.

In addition, if the patient has LV myocardial hypertrophy as a manifestation of hypertrophic cardiomyopathy or arterial hypertension, increased PV may indicate that the heart muscle can still compensate for the onset of heart failure and seeks to expel as much blood as possible into the aorta.

The normal work of the heart is an alternating cyclic alternation of contractions of the muscle layer (myocardium) and complete relaxation, during which the organ rests from the load and prepares for the next stroke. Blood is pushed into the aorta into each systole (contraction), and from there it spreads throughout the body.

The ejection fraction (EF) is a functional indicator, the ratio of the blood that has left the left ventricle to that returned to it. Special formulas are used for the calculation. As a general rule, an assessment is carried out in this way. Take the amount of blood ejected into the aorta, take the final diastolic volume (BWW, which returned). The result is multiplied by 100%, getting a specific value.

Current situation

Due to the increase in life expectancy among the elderly, the prevalence of cardiac pathology in this group increases, especially with a disturbed ejection fraction. In recent years, proven methods of drug treatment and the use of resynchronization devices, a cardioverter-defibrillator, which prolong life, improve its quality in patients with this pathology, have been developed.

However, treatment methods for a heart pathology with a normal fraction have not been determined; treatment of this pathology remains empirical. There are also no proven treatments for acute forms of cardiac decompensation (pulmonary edema). Until now, the main drugs in the treatment of this condition are diuretics, oxygen and nitro drugs. The ejection fraction, the norm, its pathology, require a serious approach to the problem.

Visualize the heart muscle and determine the work of the chambers of the heart (atria, ventricles) using Doppler cardiography. To understand how the heart works, examine its ability to contract (systolic function) and relaxation (diastolic function) of the myocardium.

Due to the increase in life expectancy among the elderly, the prevalence of cardiac pathology in this group increases, especially with a disturbed ejection fraction. In recent years, proven methods of drug treatment and the use of resynchronization devices, a cardioverter-defibrillator, which prolong life, improve its quality in patients with this pathology, have been developed.

However, treatment methods for a heart pathology with a normal fraction have not been determined; treatment of this pathology remains empirical. There are also no proven treatments for acute forms of cardiac decompensation (pulmonary edema). Until now, the main drugs in the treatment of this condition are diuretics, oxygen and nitro drugs. The ejection fraction, the norm, its pathology, require a serious approach to the problem.

Normal value of the ejection fraction of the heart, deviations of the indicator

The indicator can be reduced with the following pathologies:

  • Myocardial infarction. When scars appear on the muscles and they cannot contract properly. Moreover, after a heart attack, it is not possible to increase the fraction by medication.
  • Coronary artery disease. In this case, the blood flow decreases.
  • Failure in rhythm of contractions. It leads to impaired conduction, heart wear.
  • Cardiomyopathy It causes an increase in muscle size.

This is due to the fact that the heart muscle begins to change, its layer grows, the structure of small blood vessels deteriorates, the fibers weaken, and the absorption of blood decreases.

In addition, the causes of pathology can be hidden in:

  • Angina pectoris
  • Hypertension.
  • Pericarditis, endocarditis, myocarditis.
  • Aneurysm of the walls of the ventricle.
  • Congenital malformations of an organ or blood vessel.
  • Vasculitis.

There are predisposing factors that can also disrupt the functioning of the body. These include obesity, tumors, severe intoxication, hormonal failure, and diabetes.

First, the patient is diagnosed in order to identify the pathology that caused the decrease. Next, the administration of drugs corresponding to the diagnosis is prescribed. With ischemia, the use of nitroglycerin is indicated, with hypertension, antihypertensive drugs and surgical correction of defects are prescribed.

In addition to treating the underlying disease, the contractile function of glycosides is stabilized. These include Digoxin, Korglikon, Strofantin.

So that the cardiovascular system is not overloaded with fluid, it is recommended that you follow a diet, reduce salt and daily fluid volume.

At the same time, diuretics are shown that contribute to the removal of excess fluid: Veroshpiron, Diacarb, Diuver, Indapamide, Torasemide.

ATP inhibitors help strengthen blood vessels and thus protect the heart. When they are taken, tissue nutrition improves, the efficiency of the heart muscle and the resistance of the myocardium to load increase. This group includes: Enalapril, Perindopril, Captopril.

Beta-adrenergic blocking agents help reduce the body’s oxygen and nutritional requirements, increase the volume of myocardial contraction sites, and reduce cell death and heart rate. Their list includes: Nebivolol, Metoprolol, Bisoprolol.

Aldosterone receptor antagonists stabilize the electrolyte blood level, remove excess fluid, reduce the load on the myocardium.

Representatives of the group are Spironolactone, Eplerenone. Angiotensin 2 receptor antagonists have a similar effect, but they are somewhat stronger. Assign Valsartan, Candesartan, Olmesartan.

When the ejection fraction is low, statins can be used as adjunctive therapy to lower cholesterol and protect blood vessels. Apply Pravastatin, Fluvastatin, Simvastatin.

An increase in the indicator is rare, since physiologically this is impossible. The heart cannot expel blood more than it should be. Therefore, the level of 80% can occur in a child at an early age, athletes and patients leading an active lifestyle.

Sometimes the increase indicates myocardial hypertrophy, when the left ventricle seeks to compensate for the onset of CHF and pushes blood with considerable force.

If the indicators do not correspond to the norm, it is necessary to consult with a cardiologist and undergo an echocardioscopy to prevent the development of pathologies.

The ejection fraction (EF) is the ratio of the stroke volume (blood that enters the aorta for one contraction of the heart muscle) to the end-diastolic volume of the ventricle (blood that accumulates in the cavity during the period of relaxation, or diastole, myocardium). The resulting value is multiplied by 100% and get the final value. That is, this is the percentage of blood that pushes the ventricle during the systole, of the total volume of fluid contained in it.

The indicator calculates a computer during an ultrasonographic study of the heart chambers (echocardiography or ultrasound). It is used only for the left ventricle and directly reflects its ability to perform its function, that is, to provide adequate blood flow throughout the body.

In conditions of physiological rest, 50–75% are considered to be the normal value of PV, while during physical exertion in healthy people it increases to 80–85%. There is no further growth, since the myocardium cannot eject all the blood from the cavity of the ventricle, which will lead to cardiac arrest.

In the medical plan, only a decrease in the indicator is evaluated – this is one of the main criteria for the development of a decrease in heart performance, a sign of contractile myocardial failure. This is evidenced by the value of PV below 45%.

Such insufficiency poses a great danger to life – a small flow of blood to the organs disrupts their work, which ends with multiple organ dysfunction and ultimately leads to the death of the patient.

Given that the cause of the decrease in the volume of ejection of the left ventricle is its systolic insufficiency (as the outcome of many chronic pathologies of the heart and blood vessels), this condition cannot be completely cured. The treatment is carried out, supporting the myocardium and aimed at stabilizing the condition at the same level.

Cardiologists and therapists are involved in the monitoring and selection of therapy for patients with a low ejection fraction. Under certain conditions, the assistance of a vascular or endovascular surgeon may be required.

The ejection fraction, the norm of which is discussed below, is the main instrumental indicator that characterizes the strength of the heart muscle. Values ​​of the ejection fraction obtained by Doppler cardiography:

  • Normal rates are greater than or equal to 55%.
  • Slight deviation – 45-54%.
  • Moderate deviation – 30-44%.
  • The expressed deviation is less than 30%.

If this indicator is less than 40% – “heart strength” is reduced. Normal values ​​are above 50%, “heart strength” is good. “Gray zone” is distinguished from 40-50%. Heart failure is a combination of clinical manifestations, biochemical markers, research data (electrocardiography, dopplerography of the heart, X-ray of the lungs) that occur with a decrease in cardiac contraction force. Distinguish symptomatic and asymptomatic, systolic and diastolic insufficiency hearts.

Detonic  Color indicator calculation rate in children and adults causes low and high

In addition to treating the underlying disease, the contractile function of glycosides is stabilized. These include Digoxin, Korglikon, Strofantin. To prevent the cardiovascular system from being overloaded with liquids, it is recommended that you follow a diet, reduce salt and daily fluid volume. At the same time, diuretics are shown to help remove excess fluid:

Veroshpiron, Diakarb, Diuver, Indapamide, Torasemide. ATP inhibitors help strengthen blood vessels and thus protect the heart. When they are taken, tissue nutrition improves, the efficiency of the heart muscle and the resistance of the myocardium to load increase. This group includes: Enalapril, Perindopril, Captopril. Beta adrenergic blocking agents help reduce the body’s oxygen and nutrient requirements, increase the volume of myocardial contraction sites, reduce cell death and heart rate.

Representatives of the group are Spironolactone, Eplerenone. Angiotensin 2 receptor antagonists have a similar effect, but they are somewhat stronger. Prescribe Valsartan, Candesartan, Olmesartan. When the ejection fraction is low, statins can be used as additional therapy to reduce cholesterol and protect blood vessels.

An increase in the indicator is rare, since physiologically this is impossible. The heart cannot expel blood more than it should be. Therefore, the level of 80% can be found in a child at an early age, athletes and patients leading an active lifestyle. Sometimes an increase indicates myocardial hypertrophy, when the left ventricle seeks to compensate for the onset of heart failure and expels blood with considerable force.

The ejection fraction, the norm of which is discussed below, is the main instrumental indicator that characterizes the strength of the heart muscle.

If this indicator is less than 40% – “heart strength” is reduced. Normal values ​​are above 50%, “heart strength” is good. Allocate the “gray zone” from 40-50%.

Heart failure – a combination of clinical manifestations, biochemical markers, research data (electrocardiography, dopplerography of the heart, radiography of the lungs) that occur with a decrease in the force of contraction of the heart.

Distinguish between symptomatic and asymptomatic, systolic and diastolic heart failure.

Relevance of the problem

In the past 20 years, the incidence of heart failure among Europeans has been decreasing. But the number of patients in the middle and older population groups increases due to increased life expectancy. According to European studies (ECHOCG), a decrease in the ejection fraction was found in half of patients with symptomatic heart failure and in half of asymptomatic patients.

Patients with heart failure are less able-bodied, their quality of life and their duration are reduced. The treatment of these patients is the most expensive for them and for the state. Therefore, the search for ways to prevent the occurrence, early diagnosis and effective treatment of heart diseases remains relevant.

Studies conducted in recent decades have proven the effectiveness of a number of groups of drugs to improve prognosis and reduce mortality in patients with low heart fraction:

  • adenosine converting enzyme inhibitors (Enalapril);
  • angiotensin P antagonists (“Valsartan”);
  • beta blockers (Carvedilol);
  • aldosterone blockers (“Spironolactone”);
  • diuretics (“Torasemide”);
  • “Digoxin”.

In the last 20 years, the incidence of heart failure among Europeans has been decreasing. But the number of cases in the middle and senior groups of the population is increasing due to the increase in life expectancy.

According to European studies (echocardiography), a decrease in ejection fraction was found in half of patients with symptomatic heart failure and in half of asymptomatic patients.

Patients with heart failure are less able to work, their quality of life and its duration are reduced.

The treatment of these patients is the most expensive for both them and the state. Therefore, the search for ways to prevent the occurrence, early diagnosis and effective treatment of heart diseases remains relevant.

  • adenosine converting enzyme inhibitors (Enalapril);
  • angiotensin P antagonists (Valsartan);
  • beta blockers (Carvedilol);
  • aldosterone blockers (“Spironolactone”);
  • diuretics (“Torasem >

Ultrasound examination of the heart, as well as radiopaque or isotopic ventriculography, will help to obtain information about the ejection fraction of the left and right ventricles. Ultrasound examination is the cheapest, safest and not burdensome for the patient. Even the simplest ultrasound machines can provide an idea of ​​the cardiac output fraction.

The indicator can be calculated with radiopaque or isotropic ventriculography, as well as with ultrasound of the heart. Most often, the latter method is chosen, since it is safe, informative, and the cheapest.

Causes of abnormal ejection fraction and treatment methods

Quite often, patients are unaware of the presence of any diseases and learn about them randomly. The following conditions may be the reason for experiences and a trip to a specialist:

  • shortness of breath, both during sports, and during complete rest. A particularly indicative symptom is heavy breathing while lying down, as well as at night during sleep;
  • malaise, dizziness, frequent fainting;
  • swelling of the extremities and facial part;
  • cramps in the sternum and heart;
  • discomfort in the right side of the abdominal cavity (due to fluid retention);
  • sharp weight loss;
  • cyanosis.

All of the above signs, a qualified specialist should know and notice the patient. The doctor will direct the patient to undergo all kinds of diagnostic procedures to understand if he has abnormalities. Only after that he prescribes the proper treatment.

Violation of the normal level of the ejection fraction develops as a result of cardiac pathologies themselves especially often.

There are a lot of options in this case. From hypertension that was not treated in time to a recent heart attack (PV falls as a result of the formation of cardiosclerosis), angina pectoris and arrhythmias with a decrease in contractility.

Any disease of the muscular organ can lead to a deviation of the indicator.

Another option is vascular pathology. Vasculitis, aneurysms, other. Autoimmune or infectious origin.

Also, hormonal diseases with a decrease in the concentration of substances of the pituitary gland, adrenal glands or thyroid gland. Diabetes.

Intoxication with alcohol, drugs, salts of heavy metals and other toxic substances.

The causes of increased PV mainly become excessive physical activity. If the release is reduced, this leads to a weakening of hemodynamics (blood flow). Such a process is considered threatening.

As for the reverse phenomenon (PV is higher than normal), it does not play a large clinical role and is rarely stable.

It is carried out in the presence of at least one symptom or an alarming sign.

The reduced ejection fraction is not an independent disease. This name cannot be found in the international classifier.

This is an instrumental symptom, a functional indicator that is used to state the fact of a decrease in myocardial contractility. What is behind the deviation is a question.

It is solved by diagnostic methods:

  • Oral questioning of the patient. To objectify complaints, identify the full clinical picture.
  • The same goals are the collection of history. Lets name the probable cause of the pathological process.
  • Blood pressure measurement. Most often it is normal until a certain point. It falls in proportion to the progression of the disorder.
  • Heart rate is also being investigated. For these purposes, a routine calculation of the number of beats per minute is carried out, as well as electrocardiography.

The ECG provides information on the presence of arrhythmias, their nature and degree. It can be carried out during the day using a special Holter monitor.

This is an even more thorough study. Evaluates vital indicators for 24 hours, in dynamics.

  • Echocardiography. A key technique for identifying functional impairment. The norm of the ejection fraction of the heart is not a reason to stop the diagnosis, other pathologies are possible if there are complaints.

In automatic mode, the percentage is calculated, then the doctor makes a conclusion about the normality of the indicator in a particular patient.

The problem is that right off the bat say that within the permissible, that is not impossible. It is necessary to observe a person for at least a few days, sometimes weeks.

Therefore, it is preferable to guide the patient in a cardiology hospital.

  • Blood test for hormones (thyroid gland, pituitary, adrenal glands), general, biochemical. They can give a lot of information.
  • MRI according to indications. Consider the anatomical properties of the heart more carefully. To say whether malformations, irreversible changes in the myocardium have formed against a background of functional impairment.

Additionally, a neurologist consultation may be required. When problems with the brain are detected, cerebral symptoms join.

A routine study of reflexes allows you to evaluate the nature of the induced disturbance and take action.

Ultrasound examination of the heart

Echocardiographic examination of the cardiovascular system is a very important and also quite affordable diagnostic method. In some cases, the method is the “gold standard”, allowing you to verify a particular diagnosis. In addition, the method allows to detect latent heart failure, which does not manifest itself under intense physical exertion.

Heart failure is a syndrome that is formed due to a violation of the structure or functioning of the myocardium. Pathology of conduction or heart rhythm, inflammatory, immune, endocrine, metabolic, genetic, neoplastic processes, pregnancy can cause cardiac weakness with or without impaired ejection fraction.

Diagnosis of systolic heart failure involves: 1. ejection fraction of the heart – the norm is less than 40%; 2. stagnation in the circles of blood circulation; 3. changes in the structure of the heart (scars, foci of fibrosis, etc.). Signs of blood stasis: – dyspnea (shortness of breath), including orthopnea, nocturnal paroxysmal shortness of breath – cardiac asthma;

– expansion of the jugular veins; – crepitation in the lungs or pleural effusion; – murmurs during auscultation of the heart, cardiomegaly. A combination of several of the above symptoms, the availability of information about heart disease helps establish heart failure, but Doppler ultrasonography of the heart with determination of structural changes and assessment of the fraction is crucial myocardial ejection. In this case, the cardiac ejection fraction will be decisive, the norm after which myocardial infarction will be definitely different.

atrial natriuretic peptide (acute heart failure – more than 300 pg / ml, with chronic more than 125 pg / ml). The level of the peptide will help in determining the prognosis of the disease, choosing the optimal treatment. Patients with a preserved heart fraction are usually older, and this is more often than women. They have many concomitant pathologies, including arterial hypertension. In these patients, the level of type B natriuretic peptide in blood plasma is lower than in patients with a low fraction, but higher than in healthy ones.

The main reason for the violation of systolic (contractile) myocardial function is the development of chronic heart failure (CHF). In turn, heart failure occurs and progresses due to diseases such as:

  • Coronary heart disease – a decrease in blood flow through the coronary arteries, supplying oxygen to the heart muscle itself,
  • Myocardial infarction, especially large focal and transmural (extensive), as well as repeated ones, as a result of which normal muscle cells of the heart after a heart attack are replaced by scar tissue that does not have the ability to contract – post-infarction cardiosclerosis is formed (in the description of the ECG, you can see the abbreviation PIKS),

Reduced PV due to myocardial infarction (b). Affected areas of the heart muscle cannot contract. The most common cause of decreased cardiac output is acute or transferred myocardial infarction, accompanied by a decrease in global or local left ventricular myocardial contractility.

Violation of the normal level of the ejection fraction develops as a result of cardiac pathologies themselves especially often. There are a lot of options in this case. From hypertension that was not treated in time to a recent heart attack (PV falls as a result of the formation of cardiosclerosis), angina pectoris and arrhythmias with a decrease in contractility.

Any disease of the muscle organ can lead to a deviation of the indicator. Another option is vascular pathology. Vasculitis, aneurysms, other. Autoimmune or infectious origin.

Also, hormonal diseases with a decrease in the concentration of substances of the pituitary gland, adrenal glands or thyroid gland. Diabetes mellitus. Intoxication with alcohol, drugs, salts of heavy metals and other toxic substances. Causes of increased PV mainly become excessive physical activity. If the release is reduced, this leads to a weakening of hemodynamics (blood flow). Such a process is considered threatening. As for the reverse phenomenon (PV is higher than normal), it does not play a large clinical role and is rarely stable.

The ECG provides information on the presence of arrhythmias, their nature and degree. It can be carried out during the day using a special Holter monitor. This is an even more thorough study. Evaluates vital indicators for 24 hours, in dynamics.

In automatic mode, the percentage is calculated, then the doctor makes a conclusion about the normality of the indicator in a particular patient. The problem is that immediately say that within the permissible, that is not impossible. It is necessary to observe a person for at least a few days, sometimes weeks. Therefore, it is preferable to guide the patient in a cardiology hospital.

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Table of Contents:

  • cardiac ischemia;
  • myocardial infarction;
  • heart rhythm disturbances (arrhythmia, tachycardia);
  • cardiomyopathy.
  • heartache;
  • chest pains;
  • interruptions in the activity of the heart;
  • tachycardia;
  • shortness of breath on exertion;
  • fainting and dizziness;
  • weakness;
  • decrease in working capacity;
  • swelling of the extremities.

Treatments for low ejection fraction

Now that you know the standards for the ejection fraction, you can evaluate how your heart works. If the fraction of cardiac output of the left ventricle by echocardiography is below normal, you will need to see a doctor immediately. For a cardiologist, it is important not only to find out that heart failure exists, but also to find out the cause of this condition.

Therefore, after an ultrasound examination, other types of diagnostics can be carried out. A low ejection fraction can be a predisposing factor for poor health, swelling, and shortness of breath. Currently, the cardiologist’s arsenal has treatments for diseases that cause a low ejection fraction.

The main thing is the constant outpatient monitoring of the patient. In many cities, specialized cardiological dispensaries are organized for free dynamic monitoring of patients with heart failure. A cardiologist may prescribe conservative treatment with pills or surgical procedures.

diuretics, digoxin, ACE inhibitors or beta-blockers. Diuretic drugs slightly reduce the volume of circulating blood, and hence the amount of work for the heart. Other drugs reduce the oxygen demand of the heart muscle, make its function more effective, but less costly. Surgical treatment of a reduced fraction of cardiac output plays an increasingly important role.

Operations have been developed to restore blood flow in the coronary vessels in coronary heart disease. Surgery is also used to treat severe valvular heart disease. According to indications, artificial heart rate drivers can be installed to prevent arrhythmia in the patient and eliminate fibrillation.

When the indicator is in the range of 55-75%, this is the norm. The value is reduced from 45 to 55%. When it is up to 45, it means that the patient has heart failure. If below 35%, then irreversible disturbances in the work of the organ occur and a person needs urgent treatment.

Chronic heart failure is the main reason for the violation of the systolic (contractile) function of the myocardium, and hence the decrease in the ejection fraction. CHF development is promoted by:

  1. Cardiac ischemia is a reduced amount of blood in the coronary vessels that feed the heart with oxygen.
  2. Myocardial infarction, its large focal size and transmurality. And in the end – the replacement of healthy heart cells with scars that are unable to contract.
  3. Diseases caused by heart rhythm disturbance due to improper contraction.
  4. Cardiomyopathy – stretching or enlargement of the heart muscle. It develops as a result of hormonal disruptions, hypertension, heart disease.

Bad health, shortness of breath, swelling of the extremities indicate a low ejection fraction. How to increase the ejection fraction? Today, in modern medicine, of the ways to increase PV, therapy is in the first place. Patients are often observed on an outpatient basis, where a study is made of the state of the heart, cardiovascular system, and drug treatment.

The doctor often prescribes diuretics that can reduce the amount of blood that circulates in the system, and ultimately the load on the heart. As well as glycosides, ACE inhibitors or beta-blockers, which reduce the need for oxygen in the heart, increase effectiveness and reduce the need for heart muscle energy.

Cardiovascular surgery requires the professionalism and experience of surgeons, therefore, operations are carried out in cardiology centers.

If the patient does not have a predisposition to heart disease, then the value of the ejection fraction of the left ventricle can be successfully maintained normal.

To prevent the norm of the ejection fraction, doctors recommend:

  1. Doing sports (aerobics), light loads.
  2. Do not wear weights, go to the gym.
  3. Quitting alcohol and smoking.
  4. Healthy lifestyle.
  5. Eating iron-rich foods.
  6. Reduce salt intake.
  7. Drink water 1,5–2 liters per day.
  8. Diet.

According to statistics of the twentieth century, heart diseases mainly affected people in old age. In the st century, these pathologies have significantly “rejuvenated”. The risk group includes residents of megacities who live in conditions with a high content of car exhausts and a low oxygen content.

In this regard, it is recommended that each person at least once a year to undergo examination by a cardiologist and in parallel with other doctors.

An increasingly important role is played by surgical treatment of a reduced fraction of cardiac output. Operations have been developed to restore blood flow in the coronary vessels in coronary heart disease. Surgery is also used to treat severe valvular heart disease. According to indications, artificial heart rate drivers can be installed to prevent arrhythmia in the patient and eliminate fibrillation.

Symptoms of a reduced ejection fraction

A low ejection fraction is one of the main criteria for heart dysfunction, so patients are forced to significantly limit their labor and physical activity. Often, even simple household chores cause a worsening of the condition, which causes most of the time to spend sitting or lying in bed.

Manifestations of a decrease in the indicator are distributed according to the frequency of occurrence from the most frequent to the more rare:

  • significant loss of strength and fatigue from the usual loads;
  • respiratory failure as an increase in frequency, up to asthma attacks;
  • breathing problems are worse when lying down;
  • collaptoid states and loss of consciousness;
  • changes in vision (darkening in the eyes, “flies”);
  • pain in the projection of the heart of varying intensity;
  • increased number of heart contractions;
  • swelling of the legs and feet;
  • fluid accumulation in the chest and abdomen;
  • gradual increase in liver size;
  • progressive weight loss;
  • episodes of impaired coordination and gait;
  • periodic decrease in sensitivity and active mobility in the limbs;
  • discomfort, moderate pain in the projection of the abdomen;
  • unstable chair;
  • bouts of nausea;
  • vomiting with an admixture of blood;
  • blood in the feces.

All symptoms by which a decrease in contractile function of the heart can be suspected are due to heart failure. Therefore, the symptoms of this disease come first.

However, according to the observations of ultrasound diagnostics practitioners, the following is often observed – in patients with severe CHF, the ejection fraction indicator remains within the normal range, while in individuals with no obvious symptoms, the ejection fraction indicator is significantly reduced. Therefore, despite the absence of symptoms, patients with cardiac abnormalities must undergo echocardioscopy at least once a year.

So, the symptoms that make it possible to suspect a violation of myocardial contractility include:

  1. Attacks of shortness of breath at rest or during physical exertion, as well as lying down, especially at night,
  2. The load provoking the occurrence of shortness of breath can vary from a significant, for example, walking for long distances (we are sick), to minimal household activity, when it is difficult for the patient to perform simple manipulations – cooking, tying shoelaces, walking to the next room, etc. d
  3. Weakness, fatigue, dizziness, sometimes loss of consciousness – all this indicates that the skeletal muscles and the brain receive little blood,
  4. Swelling on the face, legs and feet, and in severe cases – in the internal cavities of the body and throughout the body (anasarca) due to impaired blood circulation through the vessels of the subcutaneous fat, in which flu >

In the absence of proper treatment for systolic myocardial dysfunction, such symptoms progress, increase and are more difficult for the patient to tolerate, so if even one of them occurs, you should consult a physician or cardiologist.

A low ejection fraction indicates serious cardiac abnormalities. Having received the diagnosis, the patient needs to reconsider his lifestyle, to eliminate excessive stress on the heart. Deterioration can cause emotional distress.

The patient complains of the following symptoms:

  • increased fatigue, weakness;
  • the occurrence of a sensation of suffocation;
  • respiratory failure;
  • difficulty breathing while lying down;
  • visual impairment;
  • loss of consciousness;
  • heartache;
  • increased heart rate;
  • swelling of the lower extremities.

At more advanced stages and with the development of secondary diseases, the following symptoms occur:

  • decreased sensitivity of the limbs;
  • enlarged liver;
  • lack of coordination;
  • weight loss;
  • nausea, vomiting, blood in the stool;
  • abdominal pain;
  • fluid accumulation in the lungs and abdomen.

Even if there are no symptoms, this does not mean that the person does not suffer from heart failure. Conversely, the pronounced above symptoms do not always result in a reduced percentage of cardiac output.

The diagnosis of “reduced ejection fraction” can be made based on the symptoms characteristic of the disease. Such patients often complain of shortness of breath attacks, both during physical exertion and at rest. Dyspnea can provoke prolonged walking, as well as performing simple household chores: mopping, cooking.

The low ejection fraction responds to various changes in the body. Symptoms are extensive and varied, determined by the root cause, the presence of concomitant diseases, the age of the patient, and many other factors. The following symptoms are most common, the presence of which indicates the nature of the problem:

  • fatigue, which is permanent;
  • fluid accumulation in the abdominal cavity and chest;
  • decreased physical capabilities of the body;
  • difficulty breathing and a constant feeling of lack of air, which increases with the horizontal position of the body;
  • frequent dizziness, which can lead to fainting;
  • decreased vision;
  • pain in the area of ​​the heart muscle;
  • swelling in the legs;
  • an increase in the size of the liver;
  • weight reduction that occurs in a short time;
  • impaired coordination of movements, loss in space and decreased sensitivity in the arms and legs;
  • stool disorders, abdominal pain, nausea and blood vomit;
  • the presence of blood in the stool.

A fall in heart contractility is caused by heart failure. In this case, the following symptoms are observed:

  • development of dyspnea at rest, during physical exertion, in a supine position (especially during night sleep);
  • a gradual decrease in the intensity of the loads for the appearance of shortness of breath (in severe cases, the simplest manipulations – cooking, walking around the room can provoke attacks);
  • general weakness, malaise, fatigue, dizziness, episodes of loss of consciousness are possible;
  • swelling of the body, face, lower leg and foot, the development of anasarca (accumulation of fluid in the internal organs and cavities);
  • soreness of the right half of the abdomen, an increase in its volume.

Without the proper adequate and timely treatment, a violation of the systolic work of the heart progresses, grows and can disrupt the normal existence of a person. A decrease in heart performance is a consequence of the disease. Therefore, before therapy it is important to determine the cause of the pathology.

For example, with ischemic heart disease, Nitroglycerin is prescribed, defects are removed in an operative way, hypertension is stopped by taking antihypertensive drugs. The patient should clearly understand that a violation of the pumping function of the heart indicates a deterioration in his condition, the development of heart failure, which has dangerous consequences and complications.

A value such as the ejection fraction of the heart is characterized by the amount of blood released into the aorta during contraction. If this indicator decreases, this indicates a deterioration in the performance of the organ and the possible occurrence of heart failure. When the fraction is very low, less than 30%, then the person is in serious danger.

At rest, the left ventricle retains blood that has got from the atrium. With contractile movement, it throws out a certain amount of it into the vascular bed. The ejection fraction (EF) of the left ventricle is calculated as the ratio of the volume of blood entering the aorta to its amount in the left ventricle during relaxation. This is the percentage of the volume of ejected body fluid.

The main symptom, when the fraction is reduced, is the appearance of shortness of breath, and regardless of the load. It can appear even due to insignificant loads when doing homework. Sometimes shortness of breath can be at night or in a supine position. Of other signs, patients note:

  • Increased weakness, fatigue and dizziness, up to loss of consciousness. This is due to a lack of blood flow and, as a consequence, oxygen starvation.
  • The appearance of edema. This is due to fluid stagnation.
  • Severe pain in the right side of the abdomen. This is noted due to congestion in the vessels of the liver, which can provoke further cirrhosis.
  • Visual impairment.
  • Pain in the area of ​​the heart with an increase in the rhythm of contractions.
  • Decreased limb sensitivity.
  • Coordination violation.
  • Nausea, vomiting.

All symptoms by which a decrease in contractile function of the heart can be suspected are due to heart failure. Therefore, the symptoms of this disease come to the first place. However, according to the observations of practicing doctors of ultrasound diagnostics, the following is often observed – in patients with severe signs of heart failure the ejection fraction indicator remains within the normal range, while in individuals with absent obvious symptoms the ejection fraction emissions are significantly reduced. Therefore, despite the absence of symptoms, patients with cardiac abnormalities must undergo echocardioscopy at least once a year.

  • Attacks of shortness of breath at rest or during physical exertion, as well as lying down, especially at night,
  • The load provoking the occurrence of shortness of breath can vary from significant, for example, walking on long distances (more than 500-1000 m), to minimal household activity, when it is difficult for the patient to perform simple manipulations – cooking, tying shoelaces, walking to the next room etc,

    The main symptom, when the fraction is reduced, is the appearance of shortness of breath, and regardless of the load. It can appear even due to insignificant loads when doing homework. Sometimes shortness of breath can be at night or in a supine position.

    Manifestations are different. Left ventricular EF indicates the strength with which blood is ejected into the aorta.

    Through the largest artery of the body, fluid connective tissue moves throughout the body, provides the structure with beneficial substances and oxygen.

    PV calculation methods

    The goals of treating patients with heart failure, when the ejection fraction of the heart is higher than normal: – alleviating the symptoms of the disease; – reducing the incidence of repeated hospitalizations; – preventing premature death. The first step in correcting heart failure is non-drug treatment: – limiting physical activity; – limiting the intake of salt; – weight loss.

    Step 1: diuretic (“Torasemide”) an angiotensin-converting enzyme inhibitor (“Enalapril”) or an angiotensin P receptor blocker (“Valsartan”) with a gradual increase in the dose to a stable state beta-blocker (“Carvedilol”). If symptoms persist, step 2 : add an aldosterone antagonist (“Veroshpiron”) or angiotensin P. receptors

    If symptoms persist, it is possible to add to treatment “Digoxin”, “Hydralazine”, nitrorepates (“Cardiket”) and / or carry out invasive interventions (installation of resynchronization devices, implantation of a cardioverter-defibrillator, heart transplantation), after conducting an ultrasound of the heart. The ejection fraction, the norm of which is described above, in this case is determined by ultrasound.

    Modern tactics for treating heart failure with angiotensin-converting enzyme inhibitors, angiotensin P receptor blockers, beta-blockers, aldosterone blockers, diuretics, nitrates, hydralazine, digoxin, omacor, if necessary, the installation of resynchronization devices and cardioverter-defibrillators has significantly increased the last two decades patients with terminal forms of this disease. This poses new challenges for doctors and researchers. It remains relevant to search for methods for replacing myocardial scar tissue.

    In addition to taking the appropriate drugs, in order to increase the fraction, all patients need to reconsider their lifestyle. To do this, it is recommended:

    • Organize proper nutrition.
    • Rest enough time.
    • Undergo physiotherapy and reflexology.
    • Monitor physical activity.
    • To be outdoors often.
    • To refuse from bad habits.

    Of course, no doctor will offer you to treat a low rate obtained by ultrasound of the heart. First, the doctor must identify the cause of the reduced EF, and then prescribe a treatment for the causative disease. Depending on it, the treatment may differ, for example, taking nitroglycerin preparations for ischemic disease, surgical correction of heart defects, antihypertensive drugs for hypertension, etc.

    In addition to drugs that affect the causative disease, the patient is prescribed medications that can improve myocardial contractility. These include cardiac glycosides (digoxin, strophanthin, korglikon). However, they are prescribed by a strictly attending physician and their independent uncontrolled use is unacceptable, since poisoning can occur – glycosidic intoxication.

    To prevent overloading the heart with a volume, that is, excess fluid, a diet is shown with a restriction of sodium chloride to 1.5 g per day and with a restriction of drinking fluid to 1.5 l per day. Diuretics (diuretics) – diacarb, diuver, veroshpiron, indapamide, torasemide, etc. are also successfully used.

    To protect the heart and blood vessels from the inside, drugs with the so-called organoprotective properties are used – ACE inhibitors. These include enalapril (Enap, Enam), perindopril (prestarium, prestanz), lisinopril, captopril (Kapoten). ARA II inhibitors, such as losartan (Lorista, Lozap), valsartan (Valz), etc., are also widely distributed among drugs with similar properties.

    The treatment regimen is always selected individually, but the patient should be prepared for the fact that the ejection fraction does not normalize immediately, and the symptoms may be disturbing for some time after the start of therapy. In some cases, the only way to cure the disease that caused the development of heart failure is surgical .

    Surgery for valve prosthetics, the installation of stents or shunts on the coronary vessels, the installation of an pacemaker, etc. may be necessary, however, in case of severe heart failure (III-IV functional class) with an extremely low ejection fraction, surgery may be contraindicated. For example, a contraindication to mitral valve replacement is a decrease in EF less than 20%, and for implantation of a pacemaker – less than 35%. Nevertheless, contraindications to operations are revealed at face-to-face examination at the cardiac surgeon.

    The ejection fraction of less than 45% is a consequence of a change in the functionality of the heart muscle against the background of the progression of the underlying disease-cause. A decrease in the indicator is a sign of irreversible changes in the tissues of the myocardium, and there is no talk of the possibility of a complete cure. All therapeutic measures are aimed at stabilizing pathological changes at their early stage and improving the patient’s quality of life at a late stage.

    The treatment complex includes:

    • correction of the main pathological process;
    • Left ventricular failure therapy.

    This article is devoted directly to the left ventricular PV and the types of its disorders, therefore, further we will focus only on this part of the treatment.

    In the first stage of any disease, the ejection fraction does not change much. The heart muscle adapts to new conditions, the muscle layer grows, small blood vessels are rebuilt. Gradually, the possibilities of the heart are exhausted, muscle fibers weaken, the amount of absorbed blood decreases.

    Other diseases that reduce cardiac output:

    • angina pectoris;
    • hypertension;
    • ventricular wall aneurysm;
    • infectious and inflammatory diseases (pericarditis, myocarditis, endocarditis);
    • myocardial dystrophy;
    • cardiomyopathy;
    • congenital pathologies, violation of the structure of the organ;
    • vasculitis;
    • vascular pathology;
    • hormonal disruptions in the body;
    • diabetes;
    • obesity;
    • tumors of the glands;
    • intoxication.

    Immediately after receiving ultrasound results on hand and determining a reduced percentage of cardiac output, the doctor will not be able to determine a treatment plan and prescribe medications. It is necessary to deal with the cause of the pathology, and not with the symptoms of a reduced ejection fraction.

    Therapy is selected after a complete diagnosis, determination of the disease and its stage. In some cases, this is drug therapy, sometimes surgical intervention.

    A person must understand that the doctor’s recommendations must be taken with full responsibility, as there is a risk of heart failure.

    First of all, medications are prescribed to eliminate the root cause of the reduced ejection fraction. A mandatory treatment point is the use of drugs that increase myocardial contractility (cardiac glycosides). The doctor selects the dosage and duration of treatment based on the results of the tests, uncontrolled intake can lead to glycoside intoxication.

    Heart failure is not only treated with pills. The patient should control the drinking regimen, the daily amount of fluid drunk should not exceed 2 liters. It is necessary to remove salt from the diet. In addition, diuretics, beta-blockers, ACE inhibitors, Digoxin are prescribed. To alleviate the condition will help medications that reduce the heart’s need for oxygen.

    They restore blood flow in coronary artery disease and eliminate severe heart defects using modern surgical methods. From arrhythmias, an artificial heart driver can be installed. The operation is not performed with a decrease in the percentage of cardiac output below 20%.

    The most popular methods of treating a low ejection fraction of the heart are the use of medications. In cases where the main cause of this pathological process is heart failure, then the patient is selected for treatment taking into account the age and characteristics of the body.

    Almost always recommended dietary restrictions, as well as a decrease in fluid intake. It is necessary to drink no more than 2 liters per day and that is exceptionally clean, still water. It is worth noting that for the entire period of treatment it is necessary to almost completely abandon the use of salt in food. A number of diuretics, ACE inhibitors, digoxin and beta-blockers are prescribed.

    All of these funds significantly reduce the volume of circulating blood masses, which accordingly reduces the level of organ work. A number of other drugs are able to reduce the body’s need for oxygen, while at the same time making its functionality the most effective and at the same time less costly. In some advanced cases, surgery is used to restore blood flow in all coronary vessels. A similar method is used for coronary disease.

    In cases of severe defects and pathological processes, only surgery in combination with drug therapy is used as a treatment. If necessary, artificial valves are installed that can prevent cardiac arrhythmias and many other heart failures, including fibrillation. Instrumental methods are used in an extreme case, when drug therapy is unable to eliminate certain problems in the work of the cardiac system.

    To prevent overloading the heart with a volume, that is, excess fluid, a diet is shown with a restriction of sodium chloride to 1.5 g per day and with a restriction of drinking fluid to 1.5 l per day. Diuretics (diuretics) – diacarb, diuver, veroshpiron, indapamide, torasemide, etc. are also successfully used.

    To protect the heart and blood vessels from the inside, drugs with the so-called organoprotective properties are used – ACE inhibitors. These include enalapril (Enap, Enam), perindopril (prestarium, prestanz), lisinopril, captopril (Kapoten). ARA II inhibitors, such as losartan (Lorista, Lozap), valsartan (Valz), etc., are also widely distributed among drugs with similar properties.

    The treatment regimen is always selected individually, but the patient should be prepared for the fact that the ejection fraction does not normalize immediately, and the symptoms may be disturbing for some time after the start of therapy.

    Conclusion

    Thus, from the presented article, one can see the practical value of the methods undertaken by doctors. The ejection fraction (norm and pathology) has not yet been fully studied. And although medicine is currently not yet perfect for combating the pathologies under consideration, we need to hope and invest a sufficient amount of investment in the development and development of scientific research in this area.

    Thus, from the presented article, one can see the practical value of the methods undertaken by doctors. The ejection fraction (norm and pathology) has not yet been fully studied. And although medicine is currently not yet perfect for combating the pathologies under consideration, we need to hope and invest a sufficient amount of investment in the development and development of scientific research in this area.

    Having suggested using the ultrasound method to visualize human organs in the 1950s, Inge Elder was not mistaken. Today, this method plays an important and sometimes key role in the diagnosis of heart disease. Let’s talk about the decoding of its indicators.

    Operative intervention

    In the case when drug therapy is ineffective, surgical treatment may be prescribed. Common methods are:

    • Installation of a cardioverter-defibrillator, pacemaker in case of heart rhythm disturbance.
    • Creating an artificial blockade to slow down ventricular contractions to stimulate different rhythms of contractions of the atria and ventricles.

    In the case when drug therapy is ineffective, surgical treatment may be prescribed.

    Home remedies

    Raising folk means fraction is almost impossible.

    Basically, this therapy is aimed at eliminating symptoms and maintaining the performance of organs. So, to prevent swelling, take decoctions of calendula, milk thistle, horsetail, yarrow, knotweed, nettle, chicory, birch buds, juniper berries, rose hips, lingonberries. They need to be drunk at intervals when similar drugs are canceled.

    1. Effective is considered a decoction of grass mistletoe, hawthorn and dried cinnamon, taken in equal quantities. Two tablespoons of the mixture is poured with a liter of boiling water and put on a small fire. After a couple of minutes, the brew is set aside and insisted for about half an hour. Having stretched, take 125 ml three times a day.
    2. The dried fruits of hawthorn in the amount of 6 tablespoons are ground and added to the motherwort herb in the same amount. After pouring a mixture of 1,5 liters of boiling water, insist a day, wrapping it well. Then it is filtered and placed in the refrigerator. You need to drink three times a day for half an hour before meals, one glass.
    3. In the treatment of cardiac pathologies, hawthorn is often used. It helps to normalize heart rate, reduce hypertension, chest pain, and fights against atherosclerosis and heart failure. Hawthorn flowers and berries help the heart, increasing its ability to pump blood. This plant helps reduce shortness of breath and fatigue. Hawthorn can be used both as a tincture and as a decoction.

    To thin the blood, willow bark, meadow clover, clover, meadowsweet, hawthorn, rakita are used.

    To sedative fees include:

    • Composition of hawthorn, cinnamon, chamomile, caraway and motherwort.
    • A decoction of St. John’s wort, mistletoe, sage, yarrow, dried calendula, calendula, horsetail and pine buds.

    For these purposes, you can buy in the pharmacy ready-made tinctures of peony, valerian, motherwort or hawthorn. In the absence of herbs, you can dilute 500 g of honey in 50 ml of water and drink in 4 divided doses throughout the day.

    It is almost impossible to increase the fraction by folk remedies. Basically, this therapy is aimed at eliminating symptoms and maintaining the performance of organs. So, to prevent swelling, take decoctions of calendula, milk thistle, horsetail, yarrow, knotweed, nettle, chicory, birch buds, juniper berries, rose hips, lingonberries. They need to be drunk at intervals when similar drugs are canceled.

  • Effective is considered a decoction of grass mistletoe, hawthorn and dried cinnamon, taken in equal quantities. Two tablespoons of the mixture is poured with a liter of boiling water and put on a small fire. After a couple of minutes, the brew is set aside and insisted for about half an hour. Having stretched, take 125 ml three times a day.
  • The dried fruits of hawthorn in the amount of 6 tablespoons are ground and added to the motherwort herb in the same amount. After pouring a mixture of 1,5 liters of boiling water, insist a day, wrapping it well. Then it is filtered and placed in the refrigerator. You need to drink three times a day for half an hour before meals, one glass.
  • In the treatment of cardiac pathologies, hawthorn is often used. It helps to normalize heart rate, reduce hypertension, chest pain, and fights against atherosclerosis and heart failure. Hawthorn flowers and berries help the heart, increasing its ability to pump blood. This plant helps reduce shortness of breath and fatigue. Hawthorn can be used both as a tincture and as a decoction.

    Heart disease in our country

    Diseases of the cardiovascular system in civilized countries are the first cause of death of the majority of the population. In Russia, coronary heart disease and other diseases of the circulatory system are extremely widespread. After 40 years, the risk of getting sick becomes especially high. Risk factors for cardiovascular problems are male gender, smoking, a sedentary lifestyle, carbohydrate metabolism disorders, high cholesterol, high blood pressure and some others.

    In the event that you have several risk factors or complaints from the cardiovascular system, then you should seek medical attention from a general practitioner or cardiologist for examination. Using special equipment, the doctor will determine the size of the left ventricular ejection fraction and other parameters, and, therefore, the presence of heart failure.

    Why can PV levels be overestimated?

    Doctors may alert patients to complaints of pain in the heart, chest pain, interruptions in heart function, palpitations, shortness of breath during physical exertion, dizziness, fainting, swelling in the legs, fatigue, decreased performance, and weakness. The first studies usually become an electrocardiogram and a biochemical blood test. Further, Holter monitoring of the electrocardiogram, bicycle ergometry and ultrasound of the heart can be performed.

    The following reasons can serve as an indication for the appointment of an ultrasound of the heart of a child:

    • heart sounds heard by a pediatrician during auscultation;
    • trembling over the area of ​​the heart, which can be felt not only by the doctor, but also the parents of the child;
    • complaints of the child about discomfort in the heart;
    • refusal of the baby from the breast, lethargic sucking, screaming and crying while breastfeeding;
    • blue of the nasolabial triangle during feeding, screaming, crying, defecating;
    • causeless cooling of hands and feet;
    • poor increase in height and weight;
    • frequent colds of the baby;
    • fainting, fainting conditions;
    • congenital heart defects (CHD) in close relatives.

    Let’s start the conversation with what the ejection fraction means. This term refers to a value that reflects the functioning of the heart muscle.

    The indicator determines the amount of blood in the percentage that is pushed out by the left ventricle as a result of contraction. When calculating the indicator, the ratio of ejected blood relative to its amount, which is in the left ventricle at the time of relaxation, is determined.

    This indicator is extremely important. Deviations from the normal level indicate serious problems in the work of the heart, which can cause the development of pathologies of the cardiovascular system and have a negative effect on the body. Therefore, it is necessary to diagnose and evaluate the ejection fraction.

    If in the survey results the indicator is 60% or more, this indicates an overestimated level of the ejection fraction. The highest value can reach 80%, the greater amount of blood left ventricle to throw into the vessels is simply incapable due to its characteristics.

    Cardiomyopathy or hypertension can trigger the development of myocardial hypertrophy. In such patients, the heart muscle can still cope with heart failure and compensates for it, trying to expel blood into a large circle of blood circulation. This can be judged by observing an increase in the PV of the left ventricle.

    As heart failure progresses, the ejection fraction slowly decreases. For patients suffering from chronic heart failure, it is extremely important to undergo periodic echocardioscopy in order to observe a decrease in EF.

    The ejection fraction is a parameter that demonstrates the amount of blood that the left ventricle expels into the aorta in the systolic phase. The ejection fraction is calculated by the proportion of the volume of blood pushed into the aorta and its volume in the left ventricle during the relaxation period.

    This parameter is calculated quite simply. It clearly demonstrates the state of the ability of the muscular membrane of the heart to contract. The ejection fraction allows one to identify the need for a person to be treated with drugs and has prognostic value for people suffering from diseases of the cardiovascular system.

    The closer to normal the value of the ejection fraction, the better the patient’s ability to contract in the myocardium, which indicates a more favorable prognosis of the disease.

    Attention. If the calculated PV value is less than the average parameters, it should be concluded that the myocardium functions with difficulty and does not adequately supply the body with blood. In this case, the person needs to be prescribed cardiac medications.

    In order to calculate the cardiac output fraction, the Teicholz or Simpson formula is used. The calculation is performed by a special program that automatically issues an assessment, taking into account information about the final systolic and diastolic LV volumes and its parameters.

    If in the survey results the indicator is 60% or more, this indicates an overestimated level of the ejection fraction. The highest value can reach 80%, the greater amount of blood left ventricle to throw into the vessels is simply incapable due to its characteristics. Typically, such results are characteristic of healthy people without other cardiac abnormalities. And for athletes with a trained heart, in which the heart muscle, contracting with considerable force, is able to push out more blood than usual.

    Forecast

    The prognosis depends on how low the patient is diagnosed. With a decrease in the value to 40-45%, the risk of cardiac arrest is small, about 10-15%. When the PV decreases to 34-39%, then the possibility of death is in the range of 20-25%.

    If this indicator becomes even lower, then the life threat to the patient increases as the PV decreases.

    It is not possible to completely get rid of the pathology, therefore, patients with this diagnosis must constantly undergo corrective therapy, which will allow them to maintain vital activity for many years.

    The ejection fraction provides information on the health of the left ventricle. In men and women, the norm is the same (55-70%), but in children the rate can reach 70-80%, which is not considered a pathology.

    The most common low fraction. To raise the indicator, it is necessary to find the cause of the pathology and organize adequate treatment. If this is not done, the patient is at risk of developing heart failure, death.

    Diseases of the cardiovascular system have been and remain the root cause of mortality in many countries of the world. Every year, 17,5 million people die from cardiological pathologies. In this article, we consider what FV of the heart demonstrates, what are the norms of this indicator, how to calculate it, in which cases you should not worry, and in which you should consult a doctor.

    The ejection fraction (EF) is a reflection of the quality of its work. In other words, this is a criterion that displays the amount of blood pushed by the left ventricle at the time of its contraction into the aortic lumen. This volume must meet certain standards: it should not be too much or too little. For the first time, patients come across this term at a cardiologist’s appointment, namely during an ultrasound examination or ECG.

    Mostly favorable for early detection. The likelihood of a quality life and simply the continuation of biological existence fall in proportion to the progression of the process.

    With competent therapy in the early and middle stages (if the ejection fraction of the left ventricle is at least 40%), the percentage of deaths is determined at 15%. It happens a little more. In the later stages, 40-60% and more.

    A complete correction can never be achieved. The process has already begun, organic disorders in the myocardium are proceeding, there is nowhere to put them.

    However, you can compensate for the situation, although treatment, with a high probability, will continue for many years, if not all life. This is not a big price.

    • If the ejection fraction of the left ventricle decreases, being in the range of 40–45%, the risk of death with cardiac arrest is about 10-15%.
    • A reduction to the level of 35–40% increases this risk to 20–25%.
    • A further decrease in exponentially worsens the prognosis for patient survival.

    There is no complete cure for the pathology, but the therapy started on time allows prolonging life and maintaining its relatively satisfactory quality.

    The prognosis depends on how low the patient is diagnosed. With a decrease in the value to 40-45%, the risk of cardiac arrest is small, about 10-15%. When EF decreases to 34-39%, then the possibility of a fatal outcome is in the range of 20-25%. If this indicator becomes even lower, then the life threat to the patient increases as the EF decreases.

    It is not possible to completely get rid of the pathology, therefore, patients with this diagnosis must constantly undergo corrective therapy, which will allow them to maintain vital activity for many years. The ejection fraction provides information about the health of the left ventricle. In men and women, the norm is the same (55-70%), but in children the rate can reach 70-80%, which is not considered a pathology.

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  • Svetlana Borszavich

    General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
    Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
    The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
    The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

    Detonic