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An EF below 40 percent is considered low. This may show that a person has heart failure with reduced ejection fraction (HFrEF) or cardiomyopathy — an enlarged, thick, or stiff heart muscle. A lower EF means that the heart’s pumping action is weaker.

Ejection fraction (EF) is a measurement, expressed as a percentage, of how much blood the left ventricle pumps out with each contraction. An ejection fraction of 60 percent means that 60 percent of the total amount of blood in the left ventricle is pushed out with each heartbeat.

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