Can ejection fraction be improved with exercise?

This is out of my area, but I have read that there is such a thing as 'cardiac rehabilitation', a specialty that the medical establishment uses for cardiac patients whose hearts have gotten weak in one way or another. Perhaps you can inquire of your cardiology team?

Hi @anet What a great question, how to exercise with the goal of increasing a low ejection fraction.

I am not a medical professional but I am quite familiar with a heart not able to provide the body with what it needs. I imagine your heart attack was scary and your activity has decreased significantly.

My experience in trying to improve my circulation is consistency. I function the best when my medications, eating and activity are consistent. Exercise and strength training makes me stronger so I experience gradual improvement. Though my situation is not exactly like yours I hope this provides some encouragement. Steady plodding!

According to the American Heart Association once your doctor gives you the go-ahead exercise may help reduce symptoms, improve mood and increasing the heart’s ability to pump blood. Exercising to improve ejection can make you feel better and reduce symptoms. Great news! As you wait for others to comment you may want to read the entire article:
- How To Improve Ejection Fraction: https://www.heart.org/en/health-topics/heart-failure/diagnosing-heart-failure/how-can-i-improve-my-low-ejection-fraction

I just read an unanswered discussion you created earlier this month, linked below. I am not sure if both discussions refer to you, or perhaps both you and your spouse are dealing with low EF. https://connect.mayoclinic.org/discussion/does-anyone-have-a-low-ejection-fraction-and-also-kidney-disease/

Have your doctors provided guidance? Are you exercising now?

Are you sure it is 15? That sounds awfully low. A normal ejection fraction is around 55-70%. Below 30% is severely abnormal, so 15 sounds extreme and your cardiologist should be giving you advice and major treatment. As for exercise improving the fraction, I would think that would depend on the condition of your heart after the heart attack. My husband had a heart attack in his 40's in a major artery but fortunately (if there is such a thing) it was low in the heart area near the apex and while he has permanent damage, he had an ejection fraction of about 38-40% after his angioplasty. As a nurse, I was very concerned about him being limited in his activities for the future as a relatively young man. One cardiologist told him to go home and "take it easy." To me this was not a very helpful response; his medical cardiologist told him to improve his condition by taking it slowly but methodically. "Start exercising by walking out one or two minutes from the house, and then back. The next day do three minutes and back. Continue adding time as you tolerate it. Guess what, he is now 80 years old, rides a bike, has hiked to the bottom of the Grand Canyon with me twice and does all his own lawn work and car maintenance. I don't know what to tell you except to keep moving--everyone can move something as Richard Simmons used to say. I wish you the best of care and well-being.

@sjm46 yes that is possible, After a bout with water around the heart which caused my heart to enlarge mine was 5% and Yes @anet it will improve, within a few months it was back up to the 30's and after a few years i got it up to 50's

@danab That is very informative! I had no idea it could be that low and a person could still function reasonably. Thank you for that helpful and inspiring information.

@sjm46 yes me also. I spent some time at home I seem to remember a couple of weeks as the meds got in my system. Then work was very understanding and found me some light duty work to do. But I was back to my normal job as an electronic technician working in substations on the communication equipment. Because I also just had a pacemaker installed i could not lift for 6 weeks over 10 pounds or reach over my head. The next time they did an ultrasound i was in the 30's but I cant remember how long after that was exactly. I want to say 6 months. that was in 2008. But it wasn't long before it got into the high 40's low 50's. It stayed there for most of the 10 years leading up to my transplant. The low EF was not the reason for it as due to the enlarged heart my main problem was electrical. So my bad paths got to the point that my pacemaker and meds were not keeping the arrythmias under control. I want to share that part as i was still in the 50 range leading up to the transplant. So if low EF is your main concern its defiantly possible to get back up to a close to normal level.

Mine was 47 and my doctor prescribed Entresto. I also started a regular exercise routine that includes walking and lifting.

My following echo test was performed recently and it had moved into the mid 60’s.

My younger sisters ejection fraction was 13. The cardiologist at the hospital put her on meds and exercise to increase. She has been going to the hospital for 15 months every Monday and Friday exercising with other heart patients. Her ejection fraction got upto 35
In June 2025 she fell ill with a flu virus and was hospitalised it was during her stay that they decided to add a pacemaker, defib, synchronizer and her ejection Fraction is now 55 back to normal. She's just joined local gym. To answer your question yes you can. Good luck.

@ann3838

@beebo yes my sister's on entresto. She got pneumonia which wasn't picked up until it had affected her heart. She's going really well now. Thank goodness.