Symptoms and causes of diastolic dysfunction
Diastolic dysfunction itself often does not cause any symptoms. However, if the problem progresses to the point that it starts to affect other organs and body parts, diastolic heart failure is diagnosed. In those situations common symptoms include:
Difficulty breathing and shortness of breath. Initially, this may only occur when exercising, but as the illness progresses, breathing can become problematic during any activity, including resting or lying down.
Unusual weight gain or swelling (edema) in the ankles, legs and abdomen.
Irregular or rapid heartbeat.
The main causes of diastolic dysfunction are:
- Chronic hypertension
- Coronary heart disease
- Aging
- Aortic stenosis – the narrowing of a heart valve
- Hypertrophic cardiomyopathy – thickened and stiffness in walls of the heart
- Restrictive cardiomyopathy – where scars or deposits have led to stiff heart muscles
Diagnosis and treatment
Both the diagnosis and treatment of isolated diastolic failure often represent a challenge, since the symptoms can be very similar to systolic heart failure. It is essential to distinguish between these two conditions as the treatment for one condition can worsen the other.
When diastolic dysfunction is diagnosed, it is by echocardiography (ECG), which enables assessment of diastolic relaxation and ventricular stiffness and thickening. It may also provide clues as to the cause of the problem.
Diastolic dysfunction is treated by aggressive management of the underlying cause. Approaches may include:
- Strict control of hypertension
- Aggressive treatment of coronary artery disease
- Careful management or arrhythmia
- The use of diuretics to control pulmonary congestion
If the underlying cause cannot be identified, a doctor will consider the possibility of undiagnosed hypertension, in which case careful monitoring is initiated. Undiagnosed coronary artery disease is also considered, in which case exercising testing can be used as a diagnostic tool.