Heart failure describes a condition where the heart is unable to pump enough blood to meet the body’s demands. Diastolic heart failure represents a specific type where the primary issue lies in the heart’s ability to relax and fill with blood. This form of heart failure still impacts the body’s overall blood supply, despite the heart’s pumping strength appearing normal.
Understanding Diastolic Heart Failure
Diastolic heart failure occurs when the heart’s main pumping chamber, the left ventricle, becomes stiff and cannot relax properly between beats. During the diastolic phase, the ventricles normally relax and fill with blood. A stiff or thickened left ventricle struggles to expand, leading to less blood filling the heart before it pumps.
Even though the heart may still pump out a normal percentage of the blood it receives (its ejection fraction is preserved), the total volume of blood pumped to the body is reduced because the ventricle did not fill completely. This reduced filling causes pressure to build up inside the heart chambers. The increased pressure can then lead to fluid accumulation in the lungs, abdomen, and legs. In contrast, systolic heart failure involves the heart’s inability to contract with enough force to pump blood effectively, leading to a reduced ejection fraction.
Common Causes and Risk Factors
Several conditions and factors contribute to diastolic heart failure. Long-standing high blood pressure is a common cause, as the heart works harder against increased resistance, leading to thickening and stiffening of the heart muscle. Aging also contributes, as the heart muscle naturally stiffens over time.
Other significant risk factors include diabetes and obesity. Coronary artery disease, which limits blood flow to the heart muscle, can also lead to muscle weakening and stiffness. Atrial fibrillation, obstructive sleep apnea, and chronic kidney disease are also associated with an increased risk.
Recognizing the Signs
Individuals with diastolic heart failure often experience symptoms related to impaired heart filling and fluid buildup. Shortness of breath is common, particularly during physical exertion or when lying flat, as fluid backs up into the lungs.
Fatigue and weakness are also frequently reported, as the body’s tissues and organs may not receive enough oxygen-rich blood. Swelling, known as edema, can appear in the legs, ankles, feet, or abdomen due to fluid retention. A persistent cough, sometimes producing white or pink phlegm, can also be a sign of fluid in the lungs.
Diagnosis and Management Approaches
Diagnosis typically involves a thorough evaluation by a healthcare provider, including a physical examination and medical history review. Several tests are then used to assess heart structure and function.
An echocardiogram is a primary diagnostic tool, using sound waves to create moving images of the heart. This test helps evaluate the heart’s ability to relax and fill, assess chamber size, and examine valve function. Blood tests, such as natriuretic peptide levels, can indicate heart strain or fluid retention. Other tests like an electrocardiogram (EKG) and chest X-rays may also be used.
Management focuses on controlling symptoms and addressing underlying conditions. Lifestyle modifications are a significant part of this strategy. These include adopting a heart-healthy diet, regular physical activity, maintaining a healthy weight, quitting smoking, and limiting alcohol consumption.
Medications are prescribed to manage the condition. Diuretics help relieve fluid buildup. Medications to control high blood pressure, such as ACE inhibitors or beta-blockers, reduce heart strain and promote relaxation. Managing conditions like diabetes and obstructive sleep apnea is also part of a comprehensive treatment plan.