Answer:
Option C, the patient is in systolic heart failure.
Explanation:
Ejection fraction (EF) is a measure of the amount of blood that is pumped from the left ventricle into peripheral circulation with each contraction of the heart muscle wall. This is represented as a percentage with the numerator being the amount of blood pumped out and the denominator being the residual blood that remains within the left ventricle. The expected range is between 50-70%.
Lower-than-typical EF can be indicative that a patient may be experiencing heart failure (HF), a condition in which blood is not adequately pumped out of the heart leading to pooling within the chambers of the heart, possibly backing up into the lungs and or the peripheral veins. EF values between 40-50% suggest borderline HF, meaning the patient is at risk for developing the condition.
Heart failure can be basically categorized in two ways -- preserved EF and reduced EF. In preserved EF, contraction is normal so EF is not below the expected range, but relaxation of the ventricles is not; this type is also known as diastolic heart failure. In reduced EF, typically with EF below 39%, the ventricles are not effectively contracting, leaving the peripheral tissues deficient of oxygen and nutrients; this type is also known as systolic heart failure.
With an EF of 35%, the patient is well below the parameters of the expected and borderline ranges, thus ruling out optimal heart functioning, diastolic HF, and risk for developing HF. They likely are experiencing HFrEF, heart failure with reduced ejection fraction, meaning they are in systolic heart failure, option C.