Systolic heart failure, also called heart failure with reduced ejection fraction, occurs when your left ventricle can’t pump blood efficiently. It’s a serious condition and can cause damage to other organs. Treatment addresses any underlying causes, such as coronary artery disease or hypertension, along with lifestyle changes.
Systolic heart failure is a condition in which the left ventricle of your heart is weak.
Your left ventricle is the largest and strongest chamber of your heart. It’s responsible for pumping oxygen-rich blood from your lungs to the rest of your body.
When the left ventricle is weak it can cause fluid to build up in your lungs, resulting in shortness of breath or fatigue. It can also cause swelling in your body, including your belly, feet and legs.
Systolic heart failure can result from coronary artery disease, high blood pressure, previous heart attack, abnormal heart rhythm, alcohol use disorder and many other causes.
It’s important to recognize symptoms of heart failure and identify the cause. There are many treatments available that can improve your heart function, quality of life and how long you live.
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Ejection fraction (EF) is a measurement that represents the percentage of blood the left ventricle pumps out with every contraction. It’s a sign of how well your heart is pumping blood.
The normal, healthy range for EF measurement is 55% to 70%. An EF under 40% may indicate systolic heart failure.
Anyone can develop systolic heart failure, but it’s more common as people age. It typically occurs in people who have had another heart-related condition.
Systolic heart failure can develop when another condition damages the left ventricle, such as:
The damage can create a scar in your heart muscle, stretch the ventricle or make it stiff. These effects will weaken the ventricle and reduce the ejection fraction. Often, addressing the causes of heart failure can improve heart function.
Signs of systolic heart failure may include:
To diagnose systolic heart failure, your healthcare provider will use several strategies. It’s essential to determine any underlying causes so they can be treated.
Diagnosis usually includes:
During a physical exam, the healthcare provider will:
Your healthcare provider may order blood work. The results can show if heart failure is causing a strain on other organs. Blood work may include measurements of:
Diagnostic imaging tests can help the healthcare team see the heart and any structural problems:
Tests to measure ejection fraction include:
Your healthcare provider may also do an electrocardiogram (EKG) to test your heart’s rate and rhythm.
The first goal of treatment for HFrEF is to treat any underlying causes. For example, if you have hypertension, you may need drugs to manage your blood pressure. If you have diabetes, you should take medications to control blood sugar. Some patients may need surgery or an implanted device to help the heart function.
Your healthcare provider may also recommend some lifestyle changes to help manage underlying conditions and keep your heart as healthy as possible:
If you have systolic heart failure, a combination of certain medications can improve your ejection fraction, symptoms and overall heart function. The idea is to reduce stress hormones in your body, and reduce the work your heart needs to do by opening up blood vessels, controlling your heart rate and lowering blood pressure. The medications below will perform each of these tasks:
You can reduce the chance of getting heart failure by taking good care of yourself:
Heart failure is a chronic (lifelong) serious condition that can shorten your lifespan. Prognosis depends on several factors, including:
Seek medical attention immediately if you experience:
Consider asking your healthcare provider:
A note from Cleveland Clinic
Systolic heart failure is a serious, chronic condition that occurs when the left ventricle can’t pump blood efficiently. Talk to your healthcare provider if you have symptoms of heart failure. Treatment for any underlying causes and good lifestyle choices can ease symptoms and help you live a longer, fuller life.
Last reviewed by a Cleveland Clinic medical professional on 06/14/2022.
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