A low EF can lead to symptoms of heart failure, such as:

However, some patients have a very low EF (less or equal to 30) and yet have minimal or even no symptoms. Other signs of heart failure or cardiomyopathy may also accompany a low ejection fraction. These include:

• An abnormal heart murmur (due to a heart valve disorder)
  
  
• A crackling sound of fluid in the lungs (rales) due to pulmonary congestion
  
  
• A rapid heartbeat (tachycardia) or other abnormal heart rhythms (arrhythmias)
  
  
• Hypertrophy or enlargement of the heart
  
  
• Liver malfunction
  
  
• Congestion of the lungs
  
  
• Swollen neck veins
  
  
• Fluid retention with accompanying weight gain and ankle swelling