Heart stiffness, often referred to as diastolic dysfunction, describes a condition where the heart muscle becomes less flexible and rigid. When the heart muscle loses elasticity, it struggles to relax fully between beats, impacting its ability to fill with blood properly. This reduced filling capacity can affect the overall function of the heart.
What is Heart Stiffness?
Heart stiffness occurs when the ventricles, the lower chambers of the heart, become rigid and cannot relax adequately during the diastolic phase. This is the period when the heart muscle expands and fills with blood after contracting. A healthy heart’s ventricles easily relax and fill, allowing efficient blood circulation. When the heart stiffens, it cannot fill properly, leading to a backup of blood in the circulatory system.
This impaired filling results in increased pressure within the heart chambers, which transmits pressure backward into the lungs and other parts of the body. Common symptoms include shortness of breath, particularly during physical activity or when lying flat. Individuals may also experience fatigue, swelling in the legs, ankles, or abdomen, and a persistent cough, as fluid can accumulate in the lungs.
Common Causes and Risk Factors
A primary factor contributing to heart stiffness is the natural aging process, as heart muscle tends to become less elastic over time. Chronic high blood pressure, or hypertension, forces the heart to work harder, which can lead to a thickening and stiffening of the heart muscle over many years. This thickening, known as left ventricular hypertrophy, directly reduces the heart’s ability to relax and fill with blood.
Diabetes also plays a role, as long-term elevated blood sugar levels can cause structural changes in the heart muscle, including fibrosis and stiffness. Excess body weight, or obesity, places additional strain on the heart, contributing to inflammation and metabolic issues that negatively affect heart health, promoting stiffening. Coronary artery disease, characterized by blockages or narrowing of the arteries supplying blood to the heart, can lead to tissue damage and subsequent stiffening of the heart muscle.
Less common contributors to heart stiffness include certain genetic conditions and infiltrative diseases. For example, amyloidosis involves the deposition of abnormal proteins, known as amyloid, within the heart tissue, causing it to become rigid and dysfunctional. Hemochromatosis, a disorder causing iron buildup, and sarcoidosis, an inflammatory disease forming granulomas, can also lead to restrictive cardiomyopathy, a form of heart stiffness.
Detecting and Managing Heart Stiffness
Detecting heart stiffness often begins with a thorough medical history and physical examination to identify symptoms and risk factors. An echocardiogram, an ultrasound of the heart, is a common diagnostic tool that provides images of the heart’s structure and function, including measurements of ventricular stiffness and filling pressures. This test helps assess how well the heart muscle is relaxing and filling with blood.
Diagnosis also involves:
- An electrocardiogram (ECG or EKG) to record the heart’s electrical activity and reveal abnormalities.
- Blood tests, such as those for B-type natriuretic peptide (BNP) or N-terminal pro-B-type natriuretic peptide (NT-proBNP), to indicate heart strain. Other tests assess kidney and thyroid function, or check for conditions like diabetes and high cholesterol.
- Cardiac MRI for more detailed imaging to identify tissue abnormalities and fibrosis within the heart muscle, offering a comprehensive view of the heart’s condition.
- Cardiac catheterization, in some cases, to directly measure pressures within the heart chambers.
Management strategies typically focus on addressing the underlying causes and alleviating symptoms. Medications are frequently prescribed; diuretics help reduce fluid buildup and swelling, while various blood pressure medications, such as ACE inhibitors, ARBs, beta-blockers, and calcium channel blockers, work to lower blood pressure and improve heart relaxation. For patients with diabetes, controlling blood sugar levels with appropriate medications can also benefit heart function.
Lifestyle modifications are also encouraged, including adopting a low-sodium diet to reduce fluid retention, engaging in regular physical activity, managing weight, and avoiding smoking and excessive alcohol consumption. In certain situations, interventional procedures like valve replacement or coronary artery bypass grafting may be considered to address specific structural issues contributing to heart stiffness.
Steps to Maintain Heart Health
Maintaining heart health involves consistent, proactive habits that can help prevent or slow the progression of heart stiffness. These include:
- Adopting a heart-healthy eating pattern, such as the DASH or Mediterranean diet, emphasizing fruits, vegetables, whole grains, and lean proteins while limiting sodium and unhealthy fats.
- Engaging in regular physical activity, such as at least 30 minutes of moderate exercise five days a week, to improve cardiovascular function and maintain arterial flexibility.
- Managing stress effectively through techniques like mindfulness or relaxation exercises.
- Avoiding tobacco products and limiting alcohol intake to reduce strain on the heart and blood vessels.
- Undergoing regular medical check-ups to monitor blood pressure, cholesterol levels, and blood sugar, allowing for early detection and management of any issues.
- Adhering to prescribed medications for existing health conditions, such as hypertension or diabetes.