Diastolic Heart Failure

What is Diastolic Heart Failure?

The inability of the heart to pump sufficient blood to meet the body’s demands due to hypertrophy of the ventricular walls, leading to a reduced preload. The ventricles’ ability to stretch and fill is impaired however, the force of contraction is not affected which preserves or even increases the ejection fraction. 

What causes Diastolic Heart Failure?

A major cause of diastolic heart failure is chronic hypertension. When the heart must pump harder to overcome a pressure resistance it causes the heart muscle to grow. Other causes include hypertrophic cardiomyopathy, which is a genetic cause of enlarged muscle cell walls. Restrictive cardiomyopathy, which results from the formation of fibrotic scar tissue that replaces dead muscle cells, impairing the heart’s ability to stretch. Valvular heart disease such as mitral stenosis. 

What are the symptoms of Diastolic Heart Failure?

Symptoms of diastolic heart failure include:

  • Shortness of breath
  • Edema
  • Fatigue
  • Pulmonary congestion
  • S4 gallop on auscultation 

How to diagnose Diastolic Heart Failure?

An echocardiogram is used to diagnose diastolic heart failure. In diastolic heart failure, there will be a preserved (55-60%) or increased ejection fraction, thickened ventricular walls, and a small left ventricle chamber. Other tests that can be done are an EKG, blood tests, chest x-ray, stress test.

What are the differential diagnoses of Diastolic Heart Failure?

  • Pulmonary edema 
  • Myocardial infarction 
  • Valvular disease
  • Pulmonary embolism

How is Diastolic Heart Failure treated?

Diastolic heart failure is treated with medications to control heart rate, blood pressure, and relieve ischemia that may be present. Medications such as ACE inhibitors, Beta Blockers, Calcium Channel Blockers, and diuretics. Lifestyle modifications such as a healthy diet and exercise, weight loss, and smoking cessation can all help with symptom control.

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