Diastolic heart failure occurs when the lower left chamber of the heart, known as the left ventricle, is unable to fill with blood during the diastolic phase (when the heart relaxes and fills with blood). This reduces the amount of blood pumped out to the body. If the left ventricle muscle becomes stiff or thickened, diastolic heart failure is the result. In this case, the heart must increase the pressure inside the ventricle to fill it with enough blood. Prolonged behavior like this causes blood to build up inside the left atrium and then the lungs. This leads to fluid congestion and heart failure symptoms.
Diastolic heart failure is, unfortunately, more common than cardiologists previously believed. Echocardiographic studies have found the condition in 15 percent of participants under 50 years old, and in about 50 percent of people over the age of 70. It is largely a disorder for women, as up to 75 percent of those diagnosed are female. The failure is diagnosed when someone with diastolic dysfunction develops an episode of pulmonary congestion severe enough to present symptoms. If diastolic heart failure occurs once, the chances of it happening again are extremely high.
The causes of diastolic heart failure development include coronary heart disease, diabetes, high blood pressure, and obesity/inactivity. The most common cause of diastolic dysfunction and failure is chronic hypertension. This leads to left ventricular hypertrophy, which decreases cardiac compliance. Chronic hypertension also leads to increased connective tissue content.
There are several risk factors that could contribute to the condition, including the following:
Diastole is when the heart returns to its relaxed state. In this condition, changes in pressure-volume of the heart lead to symptoms of diastolic heart failure. It is a complex process that is affected by factors such as heart rate, velocity of relaxation, cardiac compliance, hypertrophy, segmental wall coordination of the heart muscle, and more.
The relaxation process has four phases specialists can identify:
The challenge with early diagnosis of this condition is that diastolic dysfunction itself produces no symptoms. If anything, a gradually progressive decrease in exercise tolerance may be a warning sign. Many people with diastolic dysfunction do not even notice that symptom, especially if they live relative sedentary lives. However, severe breathlessness (dyspnea) accompanied by coughing and hyperventilation is the typical manifestation of this condition. Additionally, symptoms may be experienced in discrete episodes, which may occur randomly and without any warning. When diastolic heart failure does set in, significant symptoms are present.
Symptoms and signs of heart failure include the following:
Diastolic heart failure can lead to other health complications. These include the following:
To diagnose heart failure, patients are asked questions about their medical history and undergo a physical exam. There are advanced procedures and technology involved to effectively diagnose the condition, inform treatment, and monitor the heart. Tests can include:
As of now, there are no definitive guidelines for treating diastolic dysfunction. The condition may be present for years before any symptoms are noticeable, and by that time, the first phase of diastolic heart failure has already begun. This is why it is important to detect diastolic dysfunction early and to begin treatment before the condition worsens.
For decades, the only treatment used to manage the symptoms of diastolic heart failure was using diuretics. Diuretics are effective at reducing congestion of the heart, shifting down the pressure-volume relation. More recently, specialists are examining whether a dime-size implant is able to relieve the high pressure created by the blood backing up from the heart into the lungs.
As with many health conditions, preventative action is vital to avoiding diastolic heart failure. According to studies, nitric oxide is shown to reduce blood pressure and prevent artery blockage and stroke. By boosting the nitric oxide levels in the body with food, preventing heart failure may be possible. The following foods are able to increase nitric oxide levels in the body:
Here are some preventative measures you can take:
The prognosis of diastolic heart failure depends on the cause, the severity of symptoms, and the degree to which other organ systems are involved. Prognosis also involves the patient’s response to medications. More research and awareness on the condition may lead to earlier identification of patients who are at risk, especially before they are at the clinical stage.
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