Diastolic Heart Failure

What is diastolic heart failure?

Diastolic heart failure, also known as heart failure with preserved ejection fraction (HFpEF), is a condition in which your heart’s main pumping chamber (left ventricle) becomes stiff and unable to fill properly.

Diastolic heart failure is one of two kinds of left-sided heart failure. The other type is systolic heart failure which reduces the pumping strength of your left ventricle.

What does the left heart ventricle do?

Your heart has four chambers: two chambers on the top (right atrium and left atrium) and two chambers on the bottom (right ventricle and left ventricle). The right ventricle pumps blood only to your lungs. The left ventricle pumps blood to the rest of your body. The left ventricle is the thickest chamber in your heart.

What is the difference between diastolic and systolic?

Diastolic and systolic are the two numbers on a blood pressure reading. Every time your heart squeezes, it pumps out blood to the network of blood vessels known as the circulatory system. The force or pressure of that squeeze is called systolic blood pressure. When your heart rests between beats, the pressure in the arteries is the diastolic blood pressure. This is why your blood pressure has two numbers:

• The top number is the systolic blood pressure.
• The bottom number is the diastolic blood pressure.

How does diastolic heart failure affect my body?

When the left side of your heart stiffens, your heart:

• Can’t relax properly between beats.
• Doesn’t fill up with as much blood as it should.
• Pumps out less blood to the rest of your body than a healthy heart would.

As a result, you experience symptoms of heart failure. You might feel short of breath or fatigued (tired, no matter how much you rest). Your breathing may get worse at night when you try to lay flat. You may also notice swelling in your belly or legs (edema). These symptoms might get worse over time.

What causes diastolic heart failure?

Many conditions can contribute to diastolic heart failure. These include:

• Atrial fibrillation (Afib).
• Coronary artery disease.
• Diabetes.
• High blood pressure (hypertension).
• Obstructive sleep apnea (OSA).
• Obesity.
• Chronic kidney disease.
• Amyloidosis or other infiltrative heart diseases.

What are the symptoms of diastolic heart failure?

Diastolic heart failure has many of the same symptoms as other types of heart failure. If you have diastolic heart failure, you may experience:

• Coughing or wheezing.
• Dizziness.
• Edema (swelling), especially in the legs, ankles, feet or abdomen.
• Fatigue.
• Frequent urination.
• Shortness of breath, especially when lying flat or with exertion.
• Decreased exercise tolerance.

How is diastolic heart failure diagnosed?

Your healthcare provider asks you about your symptoms and family health history. Your provider also conducts a physical exam and listens to your heart with a stethoscope.

You may have specific tests to diagnose heart failure, such as:

• Chest X-ray to take images of your chest and heart.
• Electrocardiogram (EKG), a record of the electrical activity in your heart.
• Echocardiogram, using sound waves to evaluate the structure and function of your heart muscle and valves.
• Exercise stress test, increasing your heart rate with medicine or as you walk on a treadmill to see how your heart responds.
• Cardiac catheterization, using a catheter (thin, hollow tube) to measure your heart’s pressure and blood flow.

How is diastolic heart failure treated?

Your healthcare provider may advise you to make specific lifestyle changes. Healthy habits can improve your cardiovascular health and help your heart work more efficiently. You may feel better if you:

• Achieve and maintain a healthy weight.
• Eat a low-sodium heart failure diet.
• Treat high blood pressure.
• Wear a CPAP machine if you have sleep apnea.
• Exercise for at least 30 minutes most days of the week.
• Quit smoking and using tobacco products. Ask your provider for help with quitting if needed.

Your treatment plan may also include prescription medications. It’s important to take the medication exactly as directed.

Many people with HFpEF take medications for other heart conditions. Your provider might prescribe medications specifically for diastolic heart failure that include:

• Diuretics to help your body get rid of excess sodium and water.
• Mineralocorticoid receptor antagonists to help your body get rid of extra sodium while keeping potassium.
• Medications to lower blood pressure.

Is there a cure for diastolic heart failure?

There is no cure for diastolic heart failure. Proper treatment can help you manage symptoms and improve your heart’s function.

How can I reduce my risk of diastolic heart failure?

The best way to reduce your risk of developing diastolic heart failure is to adopt healthy habits. These habits can improve your overall heart health. They decrease your risk of heart problems.

You can reduce your risk of diastolic heart failure by:

• Eating a heart-healthy diet.
• Exercising regularly.
• Limiting alcohol intake and avoiding smoking.
• Managing conditions like diabetes, high blood pressure and high cholesterol.

What is the outlook for people with diastolic heart failure?

With treatment, you can live well with diastolic heart failure. It’s important to follow your healthcare provider’s treatment plan. Diastolic heart failure doesn’t go away, but you can manage the symptoms.

What else should I ask my healthcare provider?

You may want to ask your healthcare provider:

• What can I do to prevent heart failure from progressing?
• What foods should I avoid with diastolic heart failure?
• What can I do to manage medication side effects?
• How often do I need to see my healthcare provider for diastolic heart failure?

A note from Cleveland Clinic

Diastolic heart failure is one of the two types of left-sided heart failure. HFPEF is the same condition. Your risk of diastolic heart failure increases as you get older. You may also have a higher risk if you have underlying conditions such as diabetes or high blood pressure. Diastolic heart failure doesn’t have a cure, but you can manage the symptoms by changing your lifestyle or taking heart medications. Many people live a full and active life with diastolic heart failure.