[Diagnosis of diastolic heart failure]

Fatigue and mainly dyspnea are symptoms the most often found in patients with diastolic heart failure. Flash pulmonary oedema is one of the most often found mode of clinical presentation. The heart has a normal size at chest X ray. Hemodynamic evaluation, the gold standard, shows increase in filling pressure but is not routinely performed. Doppler echocardiography has become the reference exam. It allows demonstrating: 1. the normal systolic function of the left ventricle (normal ejection fraction); 2. existence of a structural abnormality of the diastolic dysfunction; 3. calculating the level of pulmonary pressures. In the next years, it is likely that an increased plasma level of brain natriuretic peptide (BNP) becomes mandatory for a positive diagnosis.