Diastolic Heart Failure: Symptoms and Explanation

Introduction

Diastolic heart failure, also known as heart failure with preserved ejection fraction (HFpEF), is a condition in which the heart's ability to relax and fill with blood is impaired. This leads to increased pressure in the heart and lungs, causing various symptoms.

Symptoms of Diastolic Heart Failure

The symptoms of HFpEF can be similar to those of systolic heart failure (HFrEF), but the causes and mechanisms are different. Common symptoms include:

1. Shortness of breath (Dyspnea)

• Often occurs during physical activity and can worsen over time
• Can also happen while lying down (orthopnea) or suddenly at night (paroxysmal nocturnal dyspnea)

2. Fatigue and Weakness

• Reduced blood supply to muscles leads to tiredness
• Even simple tasks may become exhausting

3. Swelling (Edema)

• Fluid retention in legs, ankles, feet, or abdomen
• Can worsen throughout the day due to gravity

4. Rapid or Irregular Heartbeat (Palpitations)

• The heart works harder to maintain blood circulation
• May be associated with atrial fibrillation, which is common in HFpEF

5. Cough and Wheezing

• Fluid buildup in the lungs can cause a persistent cough
• Often worsens when lying flat

6. Cognitive Issues

• Poor circulation can lead to confusion or difficulty concentrating
• More common in elderly patients

7. Weight Gain or Sudden Weight Change

• Caused by fluid retention
• Rapid changes may indicate worsening heart failure

Why Does This Happen?

In HFpEF, the heart muscle becomes stiff and does not relax properly between beats. This increases pressure in the left ventricle, which backs up into the lungs, leading to congestion and difficulty breathing.

Risk Factors and Comorbidities

Diastolic heart failure is often associated with: - Hypertension (high blood pressure) – Stiffens the heart muscle over time - Diabetes – Can lead to heart disease and stiffening of heart walls - Obesity – Increases workload on the heart - Atrial fibrillation – Common in HFpEF patients - Coronary artery disease – Limits blood supply to the heart

When to See a Doctor?

If you experience persistent shortness of breath, swelling, or extreme fatigue, consult a doctor. Early management can improve outcomes and prevent complications.

Source recommendations

1. American College of Cardiology/American Heart Association (ACC/AHA) Heart Failure Guidelines

1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063
2. https://www.acc.org/Guidelines
3. https://www.jacc.org/doi/10.1016/j.jacc.2023.12.024
4. https://www.acc.org/education-and-meetings/products-and-resources/features/global-cv-institute/heart-failure-guidelines
5. https://pubmed.ncbi.nlm.nih.gov/35363499/

2. European Society of Cardiology (ESC) Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure

1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Acute-and-Chronic-Heart-Failure
2. https://pubmed.ncbi.nlm.nih.gov/34447992/
3. https://academic.oup.com/eurheartj/article/42/36/3599/6358045
4. https://pubmed.ncbi.nlm.nih.gov/22611136/
5. https://academic.oup.com/eurheartj/article/44/37/3627/7246292