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We provide our users the most up-to-date and accurate information on the treatment and prevention of cardio pathologies in accordance with current American and European clinical guidelines.
The information provided on this website is for educational purposes only and should not be considered medical advice. Always consult a licensed physician for diagnosis and treatment.
Understanding Diastolic Congestive Heart Failure
Introduction
Diastolic heart failure, also known as heart failure with preserved ejection fraction (HFpEF), is a condition where the heart's ability to relax and fill with blood is impaired, leading to symptoms of congestion. Unlike systolic heart failure, where the heart does not pump effectively, in diastolic heart failure, the heart's pumping function remains relatively normal, but the ventricles become stiff and do not fill properly.
Causes and Risk Factors
Several conditions can contribute to the development of diastolic heart failure: - Hypertension (High Blood Pressure) – Chronic high blood pressure causes thickening (hypertrophy) of the heart muscle, making it stiffer. - Coronary Artery Disease (CAD) – Reduced blood supply to the heart muscle can lead to dysfunction. - Aging – As people age, the elasticity of the heart muscle decreases. - Diabetes Mellitus – Linked to structural and functional changes in the heart. - Obesity – Increases the workload on the heart. - Chronic Kidney Disease – Leads to fluid retention and increased blood pressure.
Symptoms
The symptoms of diastolic heart failure are often similar to other forms of heart failure and include: - Shortness of breath, especially during exertion or at night (orthopnea) - Fatigue and weakness - Swelling in the legs, ankles, or feet (edema) - Rapid weight gain due to fluid retention - Frequent urination at night (nocturia) - Difficulty exercising
Diagnosis
Diagnosis is made based on clinical evaluation, imaging, and laboratory tests: - Echocardiography – To assess heart structure and function, particularly left ventricular relaxation. - Brain Natriuretic Peptide (BNP) Test – Elevated levels suggest heart failure. - Cardiac MRI or CT – For a more detailed view of the heart muscle. - Electrocardiogram (ECG) – To look for arrhythmias or hypertrophy.
Treatment Strategies
While no specific medication directly reverses diastolic heart failure, treatment focuses on managing symptoms and underlying conditions:
1. Lifestyle Modifications:
- Regular Exercise – Helps improve heart flexibility.
- Low-Sodium Diet – Reduces fluid buildup and blood pressure.
- Weight Management – Helps lower the workload on the heart.
- Smoking Cessation and Alcohol Moderation – Reduce cardiovascular risks.
2. Medication Therapy:
- Blood Pressure Control – Using medications such as beta-blockers, ACE inhibitors, or ARBs to reduce heart strain.
- Diuretics – To reduce excess fluid and relieve symptoms.
- Aldosterone Antagonists – Help reduce fibrosis and improve heart relaxation.
- SGLT2 Inhibitors (for diabetic patients) – Shown to improve outcomes in HFpEF.
3. Management of Associated Conditions:
- Strict Blood Sugar Control – If you have diabetes.
- Aggressive Blood Pressure Management – Targeting under 130/80 mmHg if tolerated.
- Rhythm Control for Atrial Fibrillation – If present, to avoid worsening symptoms.
4. Advanced Therapies and Monitoring:
- Implantable Devices – For those at risk of arrhythmias.
- Regular Follow-ups – Essential for monitoring progress.
Conclusion
Diastolic heart failure is a chronic but manageable condition. Early detection and controlling risk factors can significantly impact the prognosis. If you experience persistent symptoms, consult a cardiologist for a thorough evaluation and personalized treatment plan.
Source recommendations
1. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063
- https://pubmed.ncbi.nlm.nih.gov/35378257/
- https://www.sciencedirect.com/science/article/pii/S0735109721083959
- https://professional.heart.org/en/science-news/2022-guideline-for-the-management-of-heart-failure
- https://www.sciencedirect.com/science/article/pii/S0735109721083947
2. 2021 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure
- https://pubmed.ncbi.nlm.nih.gov/34447992/
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Acute-and-Chronic-Heart-Failure
- https://academic.oup.com/eurheartj/article/42/36/3599/6358045
- https://onlinelibrary.wiley.com/doi/full/10.1002/ejhf.2333
- https://academic.oup.com/eurheartj/article/44/37/3627/7246292
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If you or your loved ones experience any of these symptoms, you should consult a doctor in time. Remember that self-medication can be dangerous, and timely diagnosis will preserve the quality and life expectancy.
The heart is an organ that does not know how to "keep silent" if something goes wrong. Chest pain, shortness of breath, swelling, dizziness, and rhythm disturbances are the symptoms that require our attention. The best prevention of heart disease is careful attention to your health, regular checkups with a doctor, and a healthy lifestyle. Take care of your heart, and it will serve you for many years!
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