A good ejection fraction for adults of any age is generally between 50% and 70%. Unlike blood pressure or cholesterol, ejection fraction doesn’t have dramatically different “normal” targets for a 30-year-old versus a 75-year-old. That said, the number does tend to shift slightly upward with age, and men and women have somewhat different baselines. Here’s what the numbers actually mean and how age fits in.
What Ejection Fraction Measures
Ejection fraction (EF) is the percentage of blood your left ventricle pumps out with each heartbeat. If your heart holds 100 mL of blood and squeezes out 60 mL, your EF is 60%. It’s one of the most common ways doctors assess how well your heart is working, and it’s typically measured during an echocardiogram (an ultrasound of the heart).
The Standard “Good” Range
The American Heart Association considers a normal ejection fraction to be between 55% and 70%. The Cleveland Clinic uses a slightly wider window of 50% to 70%. In practice, any EF at or above 50% is considered normal by most clinical guidelines. Below that, the classifications break down like this:
- 50% or above: Normal (preserved) ejection fraction
- 41% to 49%: Mildly reduced ejection fraction
- 40% or below: Reduced ejection fraction, typically indicating heart failure
An EF above 75% isn’t necessarily better. It can sometimes signal a condition called hypertrophic cardiomyopathy, where the heart muscle is abnormally thick and squeezes too forcefully.
How Ejection Fraction Changes With Age
Contrary to what you might expect, ejection fraction doesn’t decline as you get older. It actually tends to increase slightly. A study published in BMC Medical Imaging used cardiac MRI to measure heart function across four age groups in healthy adults, and the averages were:
- Ages 20 to 29: ~61%
- Ages 30 to 49: ~61%
- Ages 50 to 69: ~65%
- Age 70 and older: ~69%
The reason for this upward trend is that the heart gets stiffer and slightly smaller with age. An aging heart holds less blood per beat, but it still squeezes out a similar or even higher proportion of what it contains. So the percentage goes up even though the total volume of blood pumped per beat may decrease. This is why EF alone doesn’t tell the whole story of heart health, particularly in older adults. Someone over 70 can have a “normal” or even high EF and still have heart failure symptoms if the heart isn’t filling properly, a condition known as heart failure with preserved ejection fraction.
Differences Between Men and Women
Women consistently have higher ejection fractions than men. Data from the Dallas Heart Study, a large community-based study, found a median EF of 75% in women compared to 70% in men. That’s a meaningful gap. The researchers defined a “low” EF as below 61% for women and below 55% for men.
Despite this, most clinical guidelines still use the same EF cutoffs for both sexes. The Cleveland Clinic is one of the few sources that breaks it out: normal is 52% to 72% for men and 54% to 74% for women. This matters because a woman with an EF of 52% might be flagged as normal by standard criteria, while in reality her heart is pumping well below what’s typical for her sex. If your results are near the lower boundary of “normal,” knowing these sex-specific ranges gives you a more accurate picture.
Children and Adolescents
Normal EF in children is broadly the same as in adults, roughly 50% to 80%. The challenge with pediatric measurements is that normal values for heart size and function change rapidly with a child’s growth. A heart chamber that looks enlarged in a small toddler might be perfectly proportional in a teenager. Pediatric cardiologists interpret EF alongside the child’s age, body size, and growth trajectory rather than relying on a single fixed cutoff.
Your Test Method Affects the Number
The EF number on your report depends partly on how it was measured. The most common method is a standard 2D echocardiogram, which is quick and widely available but tends to read slightly lower than other techniques. Compared to cardiac MRI (considered the gold standard), 2D echocardiography underestimates EF by about 3 to 4 percentage points on average. In a study of 745 patients, the median EF was 60% on echo versus 63% on MRI.
That gap matters most when your EF sits near a clinical threshold. About 9% of patients in that study were classified differently depending on whether the 50% cutoff was applied to their echo result or their MRI result. Three-dimensional echocardiography narrows the gap, underestimating by only about 1.6 percentage points compared to MRI. If your doctor is making a treatment decision based on a borderline EF reading from a standard echo, they may order a cardiac MRI or 3D echo for a more precise measurement.
What a Borderline or Low EF Means
An EF in the 41% to 49% range is considered mildly reduced. It doesn’t automatically mean you have heart failure, but it does signal that your heart isn’t pumping as efficiently as it should. Your doctor will typically look at symptoms (shortness of breath, fatigue, fluid retention) alongside the number to determine whether treatment is needed.
An EF of 40% or below is the threshold for heart failure with reduced ejection fraction, the most well-studied form of heart failure. At this level, the heart is clearly struggling to meet the body’s demands. Treatment can improve EF over time in many people, sometimes significantly, so a low reading is not necessarily permanent.
The 2022 AHA/ACC guidelines also recognize heart failure with preserved ejection fraction, where EF is 50% or above but the heart still isn’t functioning properly, usually because it’s too stiff to fill with blood between beats. This is especially common in older adults and in women, which is why symptoms matter as much as the number itself.
Putting Your Number in Context
If you’re looking at a test result and wondering whether your EF is “good,” the short answer is: 50% or above is normal for any age. But a truly useful interpretation accounts for your sex, the testing method, whether the number has changed over time, and whether you have any symptoms. A single EF reading is a snapshot. Trends across multiple measurements are far more informative, especially if you’re being monitored for a heart condition. A drop of 10 percentage points over a year is more concerning than a stable reading of 52%, even though 52% technically sits at the lower edge of normal.