Q. Kindly explain about the diastolic heart failure.

Answered by Dr. Carlos L. Alviar Md, Facc and medically reviewed by Dr. Nithila A

 

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Hello doctor,

I am a 41-year-old male with 5'11" height and weight 214 pounds. Multiple sclerosis and bipolar disorder are co-morbid conditions. I was recently admitted for a heart catheterization to check for any potential blockage after an abnormal ECG, chest and chin pain, months of breathlessness, and a very strong family history of cardiovascular disease.

Fortunately, no blockages were found. However, my cardiologist informed me that I had diastolic heart failure. To be clear, he did not say diastolic dysfunction, and he said heart failure. My high blood pressure has always been controlled. My reports say,

1. Moderate tortuosity of epicardial vessels consistent with hypertension.

2. Hyperdynamic left ventricular ejection fraction of 75 to 80 %.

3. Moderate to severely elevated left ventricle end-diastolic pressure 24 mm Hg.

My cardiologist never gave me a prognosis. He told me to eat a low sodium diet and to get checked for sleep apnea (which I will do), but he never gave me a prognosis. I have dealt with health problems for a very long time. It is essential for me to know what a diastolic heart failure diagnosis means for my lifespan. I am married and have five children, and it would be nice to know what I am looking at. Kindly advice.


Related Questions:
Kindly explain about the diastolic heart failure.
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Dr. Carlos L. Alviar Md, Facc
INTERNAL MEDICINE., CHIEF RESIDENT IN INTERNAL MEDICINE., CARDIOLOGY FELLOWSHIP., TRANSLATIONAL RESEARCH.,
Cardiology, Critical Care Physician

Hello,

Welcome to icliniq.com.

I am sorry to hear that you did not receive any detailed explanation of your condition. Diastolic dysfunction is the inability of the heart to relax, which can be diagnosed with echocardiogram or with evidence of high pressures inside your heart chambers, as evidenced by the increase LVEDP (Left ventricular end-diastolic pressure) in your cardiac cath (it was 24 mmHg, and normal is considered less than 15 or 18 mmHg). The term diastolic heart failure is used when we have evidence of diastolic dysfunction as above in addition to symptoms of heart failure (the shortness of breath you described).

There is some belief that diastolic heart failure is more benign than systolic heart failure, but in reality, that is not the case. They have similar prognosis when compared in general. However, patients with advanced systolic heart failure have a worse prognosis than those with diastolic heart failure. The complicating aspect is that there are no many proven therapies that work for diastolic heart failure, other than low sodium diet, diuretics, exercise, proper eating, and lifestyle modification.

To provide a more precise diagnosis, it would be essential to understand how is your exercise tolerance, however that can be challenging with your multiple sclerosis.

I hope this information helps. I do not want you to feel discouraged but instead focus on lifestyle modification. Eating well, stress reduction (mindfulness or mediation can help) and practice physical activity.


The Probable causes:

Hypertension, and obesity.

Investigations to be done:

Possibly an exercise stress test to objectively assess your exercise capacity, sleep study, and probably a Holter or event monitor (to assess for arrhythmias or atrial fibrillation).

 

Thank you doctor,

Can you give me an estimated life expectancy?

 

Dr. Carlos L. Alviar Md, Facc
INTERNAL MEDICINE., CHIEF RESIDENT IN INTERNAL MEDICINE., CARDIOLOGY FELLOWSHIP., TRANSLATIONAL RESEARCH.,
Cardiology, Critical Care Physician

Hello,

Welcome back to icliniq.com.

Unfortunately, no test or series can tell your life expectancy. There are risk predictors for other conditions such as coronary artery disease that can be put into an algorithm and show you the risk of certain events, such as having a heart attack in 10 years, or in the case of atrial fibrillation the risk of having a strike over one year period.

However, for diastolic dysfunction or diastolic heart failure is not that simple. Moreover, we would have to take in consideration your exercise capacity. If you would like to get a more objective assessment, you can see a heart failure specialist see if they can do a cardiopulmonary stress test so that they can provide a better estimate. However, that test might not be covered by your insurance.

 
 
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Related Questions & Answers


Does high E/A ratio suggest diastolic dysfunction?
Query: Hello doctor, I want to show my echocardiogram, to know if I have diastolic dysfunction or not. I can see that the velocity is high, but the report says normal. I am not an expert, but I have read that, if E/A ratio is higher than 1.5, then it is a problem. Please help, I am worried.  Read Full »
Dr. Isaac Gana
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Answer: Hello, Welcome to icliniq.com. In order to diagnose a person to have diastolic dysfunction, there are factors that have to be met. Like ejection fraction more than 45%, the presence of diastolic stiffness, and heart failure symptoms, with changes in some laboratory test indexes. E/A ratio great...  Read Full »
 
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Query: Hello doctor, I need help reading the results of my echo a few months back. I am just not receiving the results. I had a baby a few months back and then was back in the hospital a week later with pnemounia. During my visit back in the hosiptal with pnemounia, the doctors said my blood work kept com...  Read Full »
Dr. Muhammad Zohaib Siddiq
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Answer: Hi, Welcome to icliniq.com. Your hearts' left ventricle is a bit weak (attachment removed to protect patient identity). It has a mild dysfunction. This occurs sometimes during the last month of pregnancy or five months after delivery. Many times this condition reverts to normal or almost normal wi...  Read Full »
 
Will diastolic dysfunction lead to heart failure?
Query: Hi doctor,I am a 46 year old male. My height is 184 cm and weight is 98 kg. I have been having balancing problems for over a year. It is some form of sensory ataxia. I also have compression in C4-C5 and C5-C6 cervical spine. I also have severe sleep apnea. I had some breathlessness and chest discom...  Read Full »
Dr. Vivek Maroti Celerio Mandurke
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Answer: Hello, Welcome to icliniq.com. I have seen your report (attachment removed to protect patient identity) and keen observation. Yes, diastolic dysfunction can cause heart failure. But, we need to find out the reason here. Sleep apnea is one additive factor and need to treat it. Also, you need to...  Read Full »
 
 

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