Diastolic Heart Failure Explained: Symptoms & Treatment

Learn about diastolic heart failure, its symptoms, and treatment options. Understand the condition for better management.

Introduction to Understanding Diastolic Heart Failure

You may have heard of systolic heart failure, where the heart muscle loses pumping power. However diastolic heart failure is another common type affecting the heart’s filling capacity.

This article will explain what happens to the heart with diastolic heart failure, who’s at risk, what symptoms manifest, and how it is diagnosed and treated. Gaining insight equips you to recognize signs of trouble and collaborate with your doctor in addressing this condition.

What is Diastolic Heart Failure?

With each heartbeat, the heart muscle contracts to pump oxygenated blood to the body (systole), then relaxes to fill with returning deoxygenated blood (diastole) before repeating the cycle.

Diastolic heart failure involves stiffening of the left ventricle making it difficult for the heart chamber to relax and fill adequately between beats. This reduces the efficiency of pumping sufficient blood volume to meet the body’s demands.

While less common than systolic failure, diastolic heart failure still affects around half of heart failure patients. Let’s explore more about causes, symptoms, diagnosis, and care.

Underlying Causes and Risk Factors

A variety of cardiovascular conditions can underlie diastolic heart failure:

Hypertension – Chronic high blood pressure strains the left ventricle causing thick, rigid muscle walls preventing healthy relaxation.

Aging – Heart muscle naturally stiffens with age, hampering diastolic function.

Diabetes – Raised glucose thickens heart muscle fiber interfering with relaxation.

Obesity – Excess fatty tissue strains the heart and promotes hypertension.

Coronary Artery Disease – Hardened, narrowed arteries impair blood flow further burdening the left ventricle.

Congenital Heart Defects – Being born with abnormal heart structures strains function over a lifetime.

Viral Infections – Viruses like HIV, hepatitis C, or Coxsackie B trigger inflammatory cardiomyopathy damaging diastolic function.

Amyloidosis – Abnormal protein deposits accumulate in heart tissue leading to restrictive cardiomyopathy.

Chemotherapy Drugs – Certain cancer treatment regimens are cardiotoxic, weakening the heart muscle.

These underlying issues promote inflammation, fibrosis, cardiomyocyte death, extracellular matrix alterations, small vessel disease, and oxidative stress – all interfering with the heart’s ability to relax and fill properly.

Recognizing Symptoms of Diastolic Heart Failure

Many people experience no symptoms of early diastolic heart failure as the condition advances, common symptoms include:

Shortness of Breath – Fluid often backs up into the lungs due to poor blood flow.

Fatigue/Weakness – Inadequate oxygen-rich blood circulation tires muscles.

Edema – Leaky vessels cause fluid accumulation in feet, legs, hands, or abdomen.

Coughing – Excess lung fluid triggers wet-sounding coughs.

Dizziness/Lightheadedness – Low blood volume reaching the brain causes these sensations.

Palpitations – To compensate for low function, the heart beats faster trying to increase output.

Nocturia – Urinating excessively at night results from the backed-up fluid.

Confusion – Insufficient brain blood flow creates mental changes.

Fainting – Critically low blood flow to vital organs causes temporary loss of consciousness.

Symptoms often start mild and worsen gradually as diastolic heart failure gets more severe. Seeking early medical evaluation for emerging issues provides the best opportunity to intervene and prevent decline.

How is Diastolic Heart Failure Diagnosed?

If symptoms and risk factors suggest possible diastolic heart failure physicians employ these diagnostic tests and exams:

Physical Exam – Listening to heart sounds, assessing edema, measuring blood pressure.

Blood Tests – Evaluating kidney function, electrolytes, hormone levels, and cardiac enzyme levels.

Chest X-ray – Checking heart size and identifying fluid buildup in lungs.

Electrocardiogram (EKG) – Assessing heart electrical activity, rate, and rhythm irregularities.

Echocardiography – Using ultrasound to visualize heart structure, pumping action, valve function, and relaxation patterns.

Cardiac MRI – Imaging modality produces detailed 3D videos of heart movement and chamber volumes determining ejection fraction.

Heart Catheterization – Inserts tube into heart chambers and arteries checking blood oxygen levels and pressure offering clues to diastolic function.

Stress Testing – Monitoring EKG and blood pressure with exercise provides info on functional limits.

Diagnosing diastolic issues can prove challenging as ejection fraction measurement often remains normal. Combining multiple test findings provides a more complete picture clarifying impairment in ventricular relaxation and filling.

Diastolic Heart Failure Treatment Approaches

While no cure for diastolic heart failure exists yet, various medications and interventions aim to relieve symptoms and slow further decline.

Medications help in various ways:

Beta-blockers ease the stress on the heart by slowing the rate.
ACE inhibitors or ARBs relax blood vessels lowering blood pressure.
Aldosterone antagonists promote fluid excretion.
Diuretics flush out excess fluid accumulations.

Lifestyle adjustments to embrace include:

Losing excess weight
Exercising regularly
Limiting alcohol and salt
Stopping smoking
Reducing cholesterol
Controlling diabetes

Devices like pacemakers or implantable cardioverter defibrillators regulate abnormal heart rhythms.

For advanced, unrelenting cases, heart transplantation surgery replaces the failing heart.

Ongoing monitoring, medication adjustments, and attentiveness to lifestyle factors help optimize quality of life within the limitations of progressive diastolic dysfunction. Support groups and home health aides provide helpful disease-coping resources as well.

The Outlook for Diastolic Heart Failure

Unfortunately, no cure for diastolic heart failure exists, so management focuses on symptom relief and slowing progression as the condition tends to worsen over time. However, many patients live normal lifespans when the condition is caught early and well-controlled.

Close follow-up care helps fine-tune treatment dosing to stabilize ejection fraction values and prevent acute flare-ups or events. Being vigilant for worsening fluid retention, blood pressure elevations, or new cardiac symptoms allows for rapidly addressing setbacks.

Researchers continue working toward a better understanding of mechanisms behind diastolic dysfunction in hopes of discovering future targeted therapies providing enhanced relief. For now, adhering closely to medication regimens and lifestyle modifications offers the best course for disease management.

Frequently Asked Questions About Diastolic Heart Failure

What is the life expectancy for someone with diastolic heart failure?

Studies show those with well-managed diastolic failure can enjoy similar life expectancy to peers without heart disease. Poorly controlled cases carry only a 57% survival rate at 5 years from diagnosis. Optimal self-care and treatment compliance greatly impact longevity.

Does diastolic heart failure qualify you for disability benefits?

Yes, end-stage diastolic heart failure usually meets approval criteria for Social Security disability or other impairment benefits. Documentation of ejection fraction below 40%, significant fluid retention, exercise intolerance, and New York Heart Association Class 3/4 limitations aids qualification.

Can diastolic heart failure be cured or reversed?

Currently, no cure exists to regenerate stiffened, thickened heart muscle in diastolic heart failure. However, supporting healthy function through lifestyle and medications can stabilize or sometimes mildly improve the condition. Aggressively addressing contributory factors like diabetes, hypertension and vascular disease helps slow progression.

What dietary changes help manage diastolic heart failure?

Limiting sodium to 2000mg daily, minimizing cholesterol and saturated fats, eating potassium-rich foods like bananas and spinach, and restricting fluids for advanced cases all help decrease strain on the heart. Losing excess weight also eases the burden.

How does diastolic heart failure differ from systolic failure?

Systolic failure involves poor heart contractility reducing ejection fraction. Diastolic failure stems from stiffness preventing the heart from relaxing enough to fill properly despite the ejection fraction remaining closer to normal limits. Both gradually worsen and treatment focuses on supportive care.