From the Guidelines
A normal ejection fraction is typically considered as ≥50%. This measurement represents the percentage of blood that leaves the left ventricle when it contracts compared to the total amount of blood in the ventricle when filled. An ejection fraction in this range indicates that the heart is pumping efficiently and effectively, as stated in the 2022 AHA/ACC/HFSA guideline for the management of heart failure 1. The heart muscle contracts with enough force to push an adequate amount of blood into circulation with each heartbeat. This normal function ensures proper oxygen and nutrient delivery to all tissues and organs throughout the body. If someone has a normal ejection fraction, it generally suggests their heart function is healthy, though it's essential to note that EF is just one measure of cardiac health. Other factors like heart rhythm, valve function, and blood pressure also contribute to overall cardiovascular health.
Some key points to consider:
- The classification of heart failure (HF) by left ventricular ejection fraction (LVEF) is crucial, as it affects prognosis and response to treatments 1.
- HF with preserved EF (HFpEF) is defined as LVEF ≥50%, while HF with reduced ejection fraction (HFrEF) is defined as LVEF ≤40% 1.
- Patients with HF and an LVEF between 40% and 49% are classified as having HF with mid-range EF (HFmrEF) or HF with mildly reduced EF (HFmrEF) 1.
- The diagnosis of HFmrEF and HFpEF can be challenging, and additional objective measures of cardiac dysfunction are necessary to improve diagnostic specificity 1.
- Regular cardiovascular exercise, maintaining a healthy weight, avoiding tobacco, limiting alcohol, and following a heart-healthy diet can help maintain a normal ejection fraction throughout life, as supported by the concept of using diagnostic imaging tests that are objective, quantifiable, and continuously related to disease 1.
It's also important to consider the use of computer-aided diagnostic support and machine learning in analyzing imaging data, which can help improve diagnostic accuracy and patient outcomes 1. Additionally, the 2019 ACC/AHA versus ESC guidelines on heart failure provide further insight into the classification of disease and the importance of LVEF in diagnosis and treatment 1.
From the Research
Normal Ejection Fracture
- A normal ejection fracture is not explicitly defined in the provided studies, but we can discuss fractures in general.
- Fractures can be classified into different types, and their management principles are crucial in detecting complications and enhancing bone healing 2.
- The treatment of fractures often involves operative procedures, and pain management is a critical aspect of post-operative care.
Pain Management in Fractures
- Studies have shown that acetaminophen can be an effective and safe option for pain management in patients with extremity fractures 3, 4.
- The use of non-opioid analgesics, such as acetaminophen, can reduce the need for opioid pain medication and minimize the risk of opioid-related adverse events 3, 5.
- However, the combination of non-opioid analgesics with opioids may increase the risk of serious opioid-related events (SOREs) 5.
- Regional nerve blocks have been shown to provide superior pain relief compared to intravenous opioids in some studies 6.
Analgesics Used in Fracture Management
- Various analgesics, including fentanyl, hydromorphone, morphine, and nonsteroidal anti-inflammatory drugs (NSAIDs), have been used to manage pain in patients with fractures 6.
- The safety and efficacy of an intravenous fixed-dose combination of acetaminophen and ibuprofen have been demonstrated in a multicenter study 4.
- This combination was found to be safe and well-tolerated, with a favorable risk-benefit profile, in patients requiring multiple doses of parenteral nonopioid analgesics after surgery 4.