Heart Failure with Reduced Ejection Fraction (HFrEF) is a chronic and progressive cardiovascular condition in which the left ventricle of the heart becomes weakened and is unable to pump an adequate amount of blood to meet the body’s metabolic needs. This condition is also referred to as systolic heart failure.
HFrEF is one of the leading causes of hospitalization, disability, and mortality worldwide. Early diagnosis and guideline-directed medical therapy play a crucial role in improving survival and quality of life.
What Is Ejection Fraction?
Ejection Fraction (EF) is the percentage of blood ejected from the left ventricle with each heartbeat. It is a key indicator of how well the heart is functioning.
- Normal EF: 50–70%
- Borderline EF: 41–49%
- HFrEF: 40% or less
When the ejection fraction is reduced, organs and tissues receive less oxygen-rich blood, leading to systemic symptoms.
Types of Heart Failure
- HFrEF: Heart failure with reduced ejection fraction (≤40%)
- HFpEF: Heart failure with preserved ejection fraction (≥50%)
- HFmrEF: Heart failure with mildly reduced ejection fraction (41–49%)
Causes of HFrEF
- Coronary artery disease
- Previous myocardial infarction (heart attack)
- Non-ischemic cardiomyopathy
- Long-standing hypertension
- Valvular heart disease
- Diabetes mellitus
- Alcohol or drug-induced myocardial damage
- Viral myocarditis
Common Symptoms
- Shortness of breath during activity or at rest
- Persistent fatigue and weakness
- Swelling of the legs, ankles, or abdomen
- Rapid or irregular heartbeat
- Sudden weight gain due to fluid retention
- Reduced exercise tolerance
Warning: Sudden worsening of breathlessness or chest pain may indicate a medical emergency.
Diagnosis of HFrEF
- Echocardiography: Gold standard for measuring ejection fraction
- Electrocardiogram (ECG)
- Chest X-ray
- Blood tests (BNP or NT-proBNP)
- Cardiac MRI in selected cases
ICD-10 Code
I50.2 – Systolic (congestive) heart failure
Treatment Options
Medications
- ACE inhibitors or ARBs
- ARNI (sacubitril/valsartan)
- Beta-blockers
- Mineralocorticoid receptor antagonists
- SGLT2 inhibitors
- Diuretics for symptom relief
Device-Based Therapy
- Implantable cardioverter-defibrillator (ICD)
- Cardiac resynchronization therapy (CRT)
Advanced Therapies
- Left ventricular assist device (LVAD)
- Heart transplantation in end-stage disease
Lifestyle and Self-Care
- Low-salt, heart-healthy diet
- Daily weight monitoring
- Regular physical activity as advised by a physician
- Smoking cessation
- Limiting alcohol intake
- Strict adherence to prescribed medications
Prognosis
HFrEF is typically a long-term condition; however, modern evidence-based therapies have significantly improved survival rates and quality of life for many patients.
Related Articles (Internal Links)
- Spinal Cord Compression: Causes and Treatment
- Syringomyelia Explained
- HMPV Virus: Symptoms and Prevention
Trusted External Sources
Frequently Asked Questions
Is HFrEF dangerous?
If left untreated, HFrEF can be life-threatening. Early diagnosis and appropriate treatment significantly reduce risks.
Can HFrEF be cured?
HFrEF is usually a chronic condition, but symptoms can be effectively managed with proper medical care and lifestyle changes.
Do lifestyle changes really help?
Yes, lifestyle modification is a critical component of long-term management and improves treatment outcomes.
Disclaimer: This content is for educational purposes only and does not substitute professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional.