What it means:
The left ventricle is the heart’s main pumping chamber. “Systolic dysfunction” means it isn’t squeezing as strongly as it should. The ejection fraction (EF) measures how much blood is pumped out with each beat; normal is about 55–70 %. Yours at 20–25 % means the pump is working at roughly one-third of normal strength.
Why it happens:
Common causes include previous heart attacks, long-term high blood pressure, viral infections of the heart, or certain genetic or valve conditions. Sometimes the exact cause isn’t known.
What you might notice:
Tiredness, shortness of breath, ankle swelling, and needing extra pillows at night. These come from fluid building up when the pump can’t keep pace.
How it’s treated:
Modern heart-failure care is much better than it used to be. Medicines such as sacubitril/valsartan, beta-blockers, eplerenone, SGLT2 inhibitors, and diuretics can improve symptoms and sometimes even raise EF. Controlling blood pressure, avoiding excess salt, and staying active within your limits all help.
If the heart doesn’t recover enough, devices like a pacemaker or defibrillator can be added for safety.
Take-home message:
A low EF is serious, but it’s manageable. With the right treatment plan and follow-up, many people live well for years.
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