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Diastolic heart failure. What primary care physicians need to know
1Division of Cardiology, University of Chicago, Pritzker School of Medicine, IL, USA. kspencer@medicine.bsd.uchicago.edu
Postgraduate Medicine
|January 1, 1997
Summary
Congestive heart failure (CHF) with normal systolic function but abnormal diastolic function is common. Diagnosis relies on clinical suspicion and echocardiography, with treatment focusing on congestion and contributing factors.
Area of Science:
- Cardiology
- Heart Failure Research
Background:
- Congestive heart failure (CHF) with preserved ejection fraction (diastolic CHF) presents similarly to systolic dysfunction.
- Associated conditions include coronary artery disease, hypertension, and aging.
- Clinical presentation is often indistinguishable from systolic heart failure.
Purpose of the Study:
- To outline the diagnosis and management of diastolic CHF.
- To highlight the role of echocardiography in assessing diastolic function.
- To review current and potential therapeutic strategies.
Main Methods:
- Clinical suspicion of heart failure.
- Assessment of normal left ventricular systolic performance.
- Noninvasive evaluation of diastolic performance, primarily echocardiography.
- Identification of precipitating factors like ischemia and tachycardia.
Main Results:
- Diastolic CHF is characterized by normal left ventricular systolic function.
- Echocardiography is the most reliable noninvasive method for assessing diastolic function.
- Treatment focuses on managing pulmonary congestion with diuretics and nitrates.
Conclusions:
- Diastolic CHF requires a high index of clinical suspicion and specific diagnostic approaches.
- While no direct therapy improves diastolic function, certain medications like calcium channel blockers, beta blockers, and ACE inhibitors show promise.
- Management involves addressing precipitating factors and relieving congestion.