Heart failure with reduced ejection fraction (HFrEF,hef-REF) is a form ofheart failure in which theejection fraction is reduced.[1] This is defined as aleft ventricularejection fraction (LVEF) of 40% or less. About half of heart failure patients have a reduced ejection fraction.[2] Other types of heart failure areheart failure with mildly reduced ejection fraction (HFmrEF, LVEF between 40% and 50%) andheart failure with preserved ejection fraction (HFpEF, LVEF 50% or higher).[1][3]
HFrEF may result in a variety of signs and symptoms, though these arenon-specific, so their presence cannot confirm that a person has HFrEF. The most typical symptoms areshortness of breath,orthopnea (shortness of breath when lying flat),paroxysmal nocturnal dyspnea (shortness of breath and coughing at night),fatigue, andreduced exercise tolerance, and ankle swelling (peripheral edema). The mostspecific signs, those which are most likely to indicate HFrEF as opposed to other conditions, are highjugular venous pressure (often marked by visibly distended jugular veins) and positiveabdominojugular test, athird heart sound, and anapex beat farther to the side of the body than normal.[2]