What are some tips for visual estimation of ejection fraction when trying to difference between low-normal (50-55%) and mildly reduced (45-50%)?

Differentiating between a low-normal (50–55%) and a mildly reduced (45–50%) ejection fraction (EF) is inherently difficult with visual estimation alone because the difference is subtle. When evaluating point-of-care ultrasound, it is important to consider the limitations of the device you are using. Ejection fraction is determined per the American Society of Echocardiography (ASE) using biplane methods. Most point-of-care ultrasound devices, including cart-based systems, do not perform this, as it requires specific image acquisition and software.

In my practice, I avoid using the term ejection fraction when performing cardiac ultrasound and focus instead on approximating systolic function. I would caution others to do the same. To assess sy...