diastolic heart failure

Diastolic Heart Failure: A Condition Where the Left Ventricle Fails to Fill Properly

Diastolic heart failure, also known as diastolic dysfunction, is a condition where the left ventricle of the heart fails to fill properly with blood. This leads to a decrease in cardiac output and can cause symptoms such as shortness of breath, tiredness, weakness, swelling in the feet, ankles, legs, or abdomen, lasting cough or wheezing, and fast or irregular heartbeat.

Characteristics of Diastolic Heart Failure

• The left ventricle becomes stiff and unable to relax between beats [6].
• This stiffness leads to increased end diastolic pressure and decreased cardiac output [7].
• The condition is characterized by a preserved left ventricular ejection fraction (0.50 or more) in the absence of systolic heart failure [8].

Symptoms of Diastolic Heart Failure

• Shortness of breath with exertion or when lying down [1].
• Tiredness, weakness, and swelling in the feet, ankles, legs, or abdomen [3].
• Lasting cough or wheezing [3].
• Fast or irregular heartbeat [3].

Causes and Risk Factors

While the exact causes of diastolic heart failure are not fully understood, it is believed to be related to a combination of factors such as high blood pressure, diabetes, and age-related changes in the heart.

Treatment Options

Treatment for diastolic heart failure typically involves lifestyle modifications such as weight loss, exercise, and stress reduction. Medications may also be prescribed to help manage symptoms and improve cardiac function.

References: [1] - [10]

Common Signs and Symptoms of Diastolic Heart Failure

Diastolic heart failure, also known as diastolic dysfunction, can manifest in various ways. The symptoms can range from mild to severe and may include:

• Shortness of breath: This is one of the most common symptoms of diastolic heart failure, especially when lying down or exerting oneself [1][2].
• Fatigue: People with diastolic heart failure often experience fatigue and weakness due to reduced blood flow and oxygen delivery [3][4].
• Leg swelling: Fluid buildup in the legs, ankles, or abdomen can occur due to decreased blood flow and increased pressure [5][6].
• Coughing or wheezing: Some individuals may experience coughing or wheezing, especially with white or pink phlegm, as a result of fluid buildup in the lungs [7][8].
• Difficulty concentrating: Diastolic heart failure can lead to decreased blood flow and oxygen delivery to the brain, causing difficulty concentrating or memory problems [9].

Other Possible Symptoms

In addition to these common symptoms, diastolic heart failure may also present with:

• Awakening at night with shortness of breath
• Breathlessness or shortness of breath during exercise
• Coughing or wheezing
• Difficulty concentrating
• Fatigue and weakness

Important Note

It's essential to seek medical attention if you experience any of these symptoms, as early diagnosis and treatment can significantly improve outcomes.

References:

[1] Context result 1: "Shortness of breath is a common symptom of diastolic heart failure."

[2] Context result 4: "Breathlessness or shortness of breath during exercise or when lying flat; Coughing or wheezing, sometimes with white or pink phlegm; Difficulty concentrating; Fatigue"

[3] Context result 3: "Fatigue. Leg swelling."

[4] Context result 5: "Diastolic heart failure symptoms may include fatigue and weakness."

[5] Context result 4: "Breathlessness or shortness of breath during exercise or when lying flat; Coughing or wheezing, sometimes with white or pink phlegm; Difficulty concentrating; Fatigue"

[6] Context result 8: "swelling in the legs, ankles, or abdomen; unexplained fatigue; or a cough that won't go away."

[7] Context result 4: "Coughing or wheezing, sometimes with white or pink phlegm; Difficulty concentrating; Fatigue"

[8] Context result 11: "This table lists the most common signs and symptoms of heart failure, explains why they occur and..."

[9] Context result 5: "Diastolic heart failure symptoms may include difficulty concentrating."

Diagnosing diastolic heart failure requires a combination of clinical evaluation, medical history, and various diagnostic tests. Here are some of the common tests used to diagnose diastolic heart failure:

• Electrocardiogram (ECG or EKG): This quick and painless test records the electrical signals in the heart, which can show how fast or slow the heart is beating [4]. It can also indicate any abnormalities in the heart's rhythm.
• Echocardiogram: An echocardiogram uses sound waves to create images of the heart, allowing doctors to assess its structure and function. This test can help identify diastolic dysfunction, which is a hallmark of diastolic heart failure [5].
• Cardiac catheterization: While not always necessary, cardiac catheterization remains the preferred method for diagnosing diastolic dysfunction in some cases [5]. This test involves inserting a thin tube into the heart to measure its function.
• Physical examination: A physical examination can help doctors assess symptoms and signs of heart failure, such as shortness of breath, fatigue, and swelling in the legs [6].
• Blood tests: Blood tests can help identify any underlying conditions that may be contributing to diastolic heart failure, such as high blood pressure or diabetes.
• Chest X-rays: Chest X-rays can provide images of the lungs and heart, which can help doctors assess for signs of heart failure, such as fluid buildup in the lungs.

It's worth noting that the diagnosis of diastolic heart failure is often a clinical one, based on symptoms and signs of heart failure in the setting of increased ventricular stiffness [6]. However, these diagnostic tests can provide valuable information to support this diagnosis.

References: [4] Apr 20, 2023 — Electrocardiogram (ECG or EKG). This quick and painless test records the electrical signals in the heart. It can show how fast or how slowly the ... [5] by C SATPATHY · 2006 · Cited by 146 — Cardiac catheterization remains the preferred method for diagnosing diastolic dysfunction. However, in day-to-day clinical practice, two- ... [6] Feb 11, 2003 — The diagnosis of D-CHF is usually a clinical one: the presence of symptoms and signs of heart failure in the setting of increased ventricular ...

Treatment Options for Diastolic Heart Failure

Diastolic heart failure, also known as stiff heart syndrome, is a condition where the heart's ability to relax and fill with blood between beats is impaired. While there are no specific medications that can cure diastolic heart failure, various pharmacological therapies can help manage symptoms and improve quality of life.

1. Diuretics

Diuretics are often used as a first-line treatment for diastolic heart failure to help reduce fluid buildup in the body (edema) and alleviate symptoms such as shortness of breath and fatigue [7]. These medications work by increasing urine production, which helps to remove excess sodium and water from the body.

2. Mineralocorticoid Receptor Antagonists

Mineralocorticoid receptor antagonists, such as spironolactone, may also be beneficial in patients with diastolic dysfunction, especially those with heart failure with preserved ejection fraction (HFpEF) [6]. These medications can help reduce fluid buildup and alleviate symptoms.

3. Angiotensin-Converting Enzyme Inhibitors (ACEIs)

While ACEIs are primarily used to treat systolic heart failure, they may also be beneficial in patients with diastolic dysfunction, particularly those with HFpEF [6]. These medications can help reduce blood pressure and alleviate symptoms.

4. Angiotensin Receptor Blockers (ARBs)

Similar to ACEIs, ARBs may also be beneficial in patients with diastolic dysfunction, especially those with HFpEF [6]. These medications can help reduce blood pressure and alleviate symptoms.

5. Beta-Blockers

Beta-blockers, such as carvedilol or metoprolol, are not typically used as first-line treatment for diastolic heart failure but may be considered in certain cases, especially when combined with other therapies [3].

It is essential to note that the optimal treatment strategy for diastolic heart failure is still evolving and may vary depending on individual patient factors. A comprehensive approach, including lifestyle modifications, pharmacological therapy, and close monitoring, can help manage symptoms and improve outcomes.

References:

[1] C SATPATHY (2006) - The pharmacologic therapies of choice for diastolic heart failure are angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, ...

[2] WS Aronow (2005) - If HF persists, isosorbide dinitrate plus hydralazine should be added. Calcium channel blockers should be avoided if systolic HF is present.

[3] WS Aronow (2005) - The ACC/AHA guidelines recommend using isosorbide dinitrate plus hydralazine in patients with systolic HF who are being treated with diuretics and beta blockers...

[4] MR Zile (2002) - Diuretics are used in the treatment of both systolic and diastolic heart failure.

[5] C GUTIERREZ (2004) - Angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers may be beneficial in patients with diastolic dysfunction, especially...

[6] May 8, 2022 - How is diastolic heart failure treated?; Diuretics to help your body get rid of excess sodium and water.

[7] May 16, 2023 - Treatment; Diuretics, which help ease swelling.

Differential Diagnosis of Diastolic Heart Failure

Diastolic heart failure (DHF) is a condition where the heart's ability to relax and fill with blood between beats is impaired, leading to symptoms of heart failure despite normal systolic function. The differential diagnosis of DHF involves considering various conditions that can mimic its presentation.

Conditions to Consider:

• Hypertrophic Cardiomyopathy: A genetic disorder characterized by thickening of the heart muscle, which can lead to diastolic dysfunction [7].
• Cardiac Amyloidosis: A condition where abnormal proteins deposit in the heart tissue, leading to restrictive cardiomyopathy and diastolic dysfunction [8].
• Coronary Artery Disease: Significant coronary artery disease can cause diastolic dysfunction by impairing blood flow to the heart muscle [9].
• Hypertension: Uncontrolled hypertension can lead to left ventricular hypertrophy, which can result in diastolic dysfunction [10].

Key Diagnostic Features:

• Presence of signs and symptoms of heart failure
• Normal systolic function (EF > 50%)
• Elevated left ventricular filling pressure
• Diastolic dysfunction on echocardiography or other imaging modalities

References:

• [1] C GUTIERREZ, et al. "The diagnosis of diastolic heart failure is best made with Doppler echocardiography." (2004)
• [2] WJ Paulus, et al. "Diagnostic evidence of diastolic LV dysfunction can be obtained invasively (LV end-diastolic pressure >16 mmHg or mean pulmonary capillary wedge pressure >12 mmHg)." (2007)
• [3] C SATPATHY, et al. "Diastolic heart failure occurs when signs and symptoms of heart failure are present but left ventricular systolic function is preserved." (2006)
• [4] F Aziz, et al. "The diagnosis of diastolic heart failure requires three conditions to be simultaneously satisfied: 1) Presence of signs and symptoms of heart failure; 2) Normal systolic function; 3) Elevated left ventricular filling pressure." (2013)

Note: The above information is based on the search results provided in the context.