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Lessons · Medicine foundations · ejection fraction

Ejection fraction: the share of a full ventricle that leaves

Ejection fraction is the stroke volume divided by the volume in the ventricle at the end of filling, written as a percentage.

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What it is for

It is the one number from an echocardiogram report that everybody quotes, and it is a fraction, not a volume. Knowing that the denominator is the full ventricle and not the empty one is the difference between a figure that makes sense and a figure above one hundred percent.

How to think about it

If you are given the two volumes, subtract to get the stroke volume first. Then divide by the end-diastolic volume, the fuller of the two. Multiply by 100 for a percentage. The answer is always between zero and one hundred; anything else means the division went the wrong way up.

Worked example

End-diastolic volume 120 mL, end-systolic volume 50 mL
Full, then empty. The bigger number is the full one.
Stroke volume = 120 − 50 = 70 mL
What actually left the ventricle in one beat.
EF = 70 / 120 = 0.583, a fraction of one
Divided by the full volume, never by the empty one.
0.583 × 100 = 58.3 %
As a percentage, to one decimal place.

Your turn

The end-diastolic volume is 140 mL and the stroke volume is 63 mL. Write the line that gives the ejection fraction as a percentage.

EF = 63 / 140 × 100 =  %

The trap

Dividing by the end-systolic volume. It is the smaller number, so the answer comes out bigger than one hundred percent, which is the arithmetic telling you plainly that the denominator is wrong.

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