ERIC MICHELSON, MD: Normally, the ejection fraction at rest, sitting quietly, might be a number of approximately 55 percent. Patients who have had some damage to the heart will have an ejection fraction often that's some number less than that 55 percent. Many patients often remain asymptomatic or only minimally symptomatic when the ejection fraction might be even 40 or 45 percent. Typically, as the ejection fraction begins to drop below a number such as 40, many more patients are typically symptomatic, and patients whose ejection fraction is less than 35 percent more often than not will not be able to do all the things they'd previously been able to do. It might be such patients have easy fatigability. They may have shortness of breath. They may even have difficulty sleeping at night.
ANNOUNCER: Although most patients don't know if their ejection fraction is low, it is important to consult a physician if you have health concerns or risk factors related to heart disease.
ERIC MICHELSON, MD: So patients who have cardiovascular risk factors or conditions and begin to develop symptoms such as easy fatigability, inability to do the activities that they usually do with having some symptoms, being short of breath, having trouble sleeping, seeing that their ankles are swollen, such patients should not just assume it's part of the normal everyday aging process, but should seek medical attention.
NANETTE KASS-WENGER, MD: The patient who has a low ejection fraction at times may be completely free of symptoms, have a perfectly normal exercise tolerance, not have shortness of breath, and these are the patients where we as clinicians are challenged to make the diagnosis, because these are the patients where the institution of appropriate medical treatments has the likelihood of preventing the progression of the disease or preventing adverse consequences.