Q. Will diastolic dysfunction lead to heart failure?
Hi doctor,
I am a 46 year old male. My height is six feet and weight is 216 pounds. 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 discomfort last year. I had a positive TMT and had an angiogram. The result was minor plaques. Since then, I was given Ecosprin 75, Monotrate 10, Dilzem 30 and Atorva 10. Again, I have breathlessness. Also, my chest pain is on and off. I feel fatigued and tired. Again, I had an ECG and Echo. The ECG was similar to the last time with T-wave inversion. Last year Echo showed mild concentric LVH and mild diastolic dysfunction. My latest echo reported mild concentric LVH, moderate diastolic dysfunction with increased LVEDP, dilated LA, sclerosed aortic valve and mild PAH (PASP=40mmHg). I have enclosed the above reports for your reference. Are my symptoms of breathlessness and fatigue due to diastolic dysfunction? Or due to my sleep apnea? I am not able to use CPAP due to body jerks and discomfort with CPAP. Is this diastolic dysfunction serious? Will it lead to heart failure? My BP is usually 140 to 150/80 mmHg. Is there a chance for minor blocks in arteries having become bigger? What course of action should I follow now?
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 control your hypertension more. Reduction of weight along with medication will help to decrease diastolic dysfunction and mostly your symptoms.
Thank you doctor,
Thank you for your prompt response. Are the dilated LA, sclerosed aorta, concentric LVH and mild PAH a cause for worry? Do I need to repeat TMT? Is diastolic dysfunction worsened compared to last time?
Hi,
Welcome back to icliniq.com.
Sclerosis of the valve is age related. So, no need to worry now as your pressure across aortic valve is normal. TMT (treadmill test) was positive last time, which was a false positive. So, it will be again false positive. Your history is not suggested for exertion angina or angiography. So, most probably your sleep apnea and may be hypertension are the reason for diastolic dysfunction. If I rely only on a printed report, then, yes, increased diastolic dysfunction is a problem. Diastolic dysfunction will lead to increased in LA (left atrium) size and raised PA pressure (pulmonary artery). It is nothing but heart fails to relax and increases the pressure in LA and the lungs.
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