HFpEF, also known as heart failure with preserved ejection fraction or diastolic heart failure, is a form of heart failure in which the left ventricle or the heart’s main pumping chamber becomes unable to fill as it should and becomes stiff.
Diastolic dysfunction represents one of the two distinct kinds of heart failures on the left side. The other one is referred to as systolic heart failure, where the patient’s left ventricle faces reduced pumping strength.
In this article, Dr. Ivan Carreras, MD, and his professional medical team discuss the characteristics of heart failure with preserved ejection fraction, together with treatment and management options for patients.
The Role of The Left Heart Ventricle
As you may know, the human heart has four different chambers. Two of them are located on the heart’s top and are called the left and right atriums. Also, two chambers can be found on the heart’s lower part. These are the left and right heart ventricles. The latter is responsible for pumping blood only to the lungs, while the left heart ventricle pumps blood to the rest of the body. Needless to say, the left ventricle is the thickest heart chamber.
Systolic vs. Diastolic Dysnfiction
These essentially refer to two different numbers on blood pressure readings. Every time the heart squeezes, the organ pumps blood to the circulatory system, a complex network of blood vessels. The pressure or force of that squeeze is what experts call systolic blood pressure. And when the heart rests in between two contractions, you have diastolic blood pressure, which is the pressure in the arteries.
Simply put, this is why blood pressure readings have two numbers, with the bottom number being the diastolic pressure and the top number being the systolic blood pressure.
The Effects of Heart Failure With Preserved Ejection Fraction on the Body
When a patient is diagnosed with diastolic dysfunction, this means that their heart:
- Is unable to relax properly between each squeeze (heartbeat).
- Pumps less blood to the rest of the organs and body when compared to a heart with a properly functioning left heart ventricle.
- It doesn’t fill up with the amount of blood it otherwise should.
And because of this, patients may experience heart failure symptoms like shortness of breath and fatigue. Also, it may become more challenging for patients to breathe properly at night when they lay flat on the bed. Edema in the legs and belly may also be a prevalent problem.
Causes and Symptoms
What exactly causes these problems in the left heart ventricle? Experts agree that several conditions may contribute to its development, and they include:
- Diabetes
- Coronary artery disease
- Atrial fibrillation
- OSA or obstructive sleep apnea
- Obesity
- High blood pressure
- Chronic kidney disease
- Amyloidosis or other infiltrative heart conditions
When assessing symptoms, it’s evident that diastolic dysfunction shares many of the same symptoms as other heart disease types. As such, if you have diastolic heart failure, you may experience the following:
- Fatigue
- Dizziness
- Swelling in the ankles, legs, belly, or feet
- Decreased tolerance to physical exercise
- Wheezing
- Frequent urination
- Shortness of breath (which gets worse when you are lying flat)
Diagnosing Heart Failure With Preserved Ejection Fraction
When it’s suspected that the patient has left heart ventricle dysfunction, their healthcare provider will ask them about their symptoms and family medical history. Furthermore, the doctor will conduct a series of physical exams and listen to the patient’s heartbeat with a stethoscope.
Here’s a list of specific tests that experts may use to diagnose heart failure:
- Echocardiogram: This device uses sound waves to show and evaluate the function and structure of the heart and its valves.
- Chest X-ray: This test takes images of the heart and chest.
- EKG or electrocardiogram: This test is able to record the heart’s electrical activity.
- Cardiac catheterization: This test involves using a thin and hollow tube (catheter) which is used to measure the blood flow and pressure.
Diastolic Heart Failure Treatment
After establishing the diagnosis and the correct diastolic heart failure stage, as a part of condition management and treatment, your healthcare provider may recommend certain lifestyle changes to improve your general cardiovascular health, which will help your heart work better. Symptoms may improve through the following changes:
- Reaching and maintaining a healthy weight
- Addressing high blood pressure
- Avoiding high-sodium foods
- Using a CPAP machine if sleep apnea is the primary cause of the condition
- Quitting smoking and avoiding tobacco products altogether
Additionally, the treatment/management plan may also include specific prescription medications, which should be taken exactly as directed to avoid issues.
As a matter of fact, many patients with heart failure with preserved ejection fraction are already taking some kind of medication for other heart conditions. Still, your doctor may prescribe specific meds to address diastolic dysfunction. These may include the following:
- Diuretics to help with edema and excess sodium
- Blood pressure medication to help keep hypertension under control
- Mineralocorticoid receptor antagonists to help the body keep potassium while getting rid of sodium
Unfortunately, there’s no cure for the condition. As such, treatment plans mainly focus on symptom management and heart function improvement.
How Can the Condition Be Prevented?
The best way to reduce the risk of left heart ventricle dysfunction is to live a healthy lifestyle that will improve overall health and decrease the risk of any heart issues altogether.
That said, you can reduce your risk by:
- Engaging in regular exercise
- Limiting your alcohol intake
- Avoiding smoking
- Eating a heart-healthy diet
- Keeping hypertension, high cholesterol, and diabetes under control
Prognosis
Luckily, patients can live well with diastolic dysfunction with proper treatment and the necessary lifestyle habits. Because of this, patients must remember to follow the treatment plan of their healthcare provider, especially in more severe diastolic heart failure stages.
Furthermore, when talking about the management/treatment plan, you and your doctor will also discuss the strategies that will prevent the issue from progressing. They will also list the foods you should avoid and discuss approaches to help mitigate the side effects of certain medications. Lastly, you will also discuss the frequency of checkups.
It’s All About Compassionate Expert Care
Unfortunately, the risks of developing this type of heart failure increase as we get older, and other heart and health conditions (like hypertension and diabetes) make us develop it even sooner. And even though there’s no cure for diastolic heart problems, patients can mitigate and combat its effects with lifestyle changes and medications.
Also, the help of an expert healthcare provider with years of experience is crucial for successful condition management. This is where we at Carreras Medical Center can help. Our experts are among the most compassionate and knowledgeable professionals regarding exceptional chronic care management in Hialeah, Fl, and the wider Miami area.
That said, if you have any questions or concerns about the condition, feel free to reach out to us. We strive only for one thing: to help our patients whenever possible.
