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Diastolic Heart Failure: Diagnosis & Treatment Options
Posted on March 1, 2019
Diastolic Heart Failure, also known as Diastolic-Dysfunction or DHF is one of the most significant types of heart failure. It occurs when the muscles of the left ventricle (the heart’s left lower chamber) become thickened or stiffened than usual. In this condition, when the heart pumps, it cannot relax and hold much blood as expected. The ventricle, therefore, is able to fill up with less blood, meaning little is expelled out to the rest of the body.
The condition is known to contribute to about 30 to 50 percent of the total occurrences of heart-failure and in most countries, it’s considered as one of the major causes of mortality as well as morbidity. In general, heart-failure, being one of the many diseases associated with age is regarded as the primary cause of hospital admissions for people over 65 years of age. It affects about 5 million people in the US with more than 4,50,000 newly discovered cases every year. Additionally, the death rate remains significantly great with almost 11% of sufferers dying within a period of 6 to 12 years. (Source: https://www.ncbi.nlm.nih.gov )
Apart from DHF, heart failure can occur as a result of the other complication referred to as Systolic Heart Failure or Systolic-Dysfunction. This happens when the heart’s left lower chamber cannot contract as expected due to the thickening or stiffening of the muscle. Patients with this condition have a similar number of hospital admissions to the diastolic dysfunction. Several studies have reported that DHF has a lower mortality rate per year than systolic dysfunction and that women are more prone to the condition as compared to men.
With DHF, it becomes very difficult for the heart to provide the whole body with all its requirements. In most cases, the heart raises the diastolic pressure in order to satisfy the metabolic essentials required to support the normal life.
Causes and Symptoms of Diastolic Heart Failure
DHF is mainly caused by aging. As individuals become older, the body organs such as the heart get older too. This makes them less effective. The vessels that carry blood also become less elastic increasing the risk of being thicker and more rigid. So, older people are more likely to get the disease as compared to younger people.
Hypertension is another cause of DHF. People who have HBP are more likely to succumb to heart failure since their hearts seem to do work extra harder in order to satisfy the requirements of the entire body. This extra work is what keeps the majority of people suffering from this condition alive. However, in the event, the muscles-of-the-heart may thicken, get bigger, and stiffer leading to diastolic heart failure.
Other causes include inactivity/obesity, CAD (coronary artery disease), atrial fibrillation, living a sedentary lifestyle, and diabetes.
Symptoms linked with this heart disease include nausea, swelling in the abdomen, ankles, feet, and legs, shortness of breath, irregular or faster heartbeat, wheezing or coughing that lasts, confusion, dizziness, tiredness and weakness, and sudden weight gain.
Diagnosis of Diastolic Heart Failure
To decide whether one has DHF, the doctor will perform several tests and also obtain the patient’s medical history. In addition, a physical examination will be necessary to diagnose the condition.
The following are the common procedures carried out when one has diastolic dysfunction.
EKG (Electrocardiogram) Test
The purpose of this test is to access the heart’s electrical activities. This can help identify the parts of the heart that are damaged, overworked, or even enlarged. Several electrodes (about 15 of them) are attached to the legs, chest or arms to measure the current of electricity within the heart.
Echocardiogram Test
This is a medical-imaging examination that uses ultrasound technology. It takes moving images of the valves as well as the heart chambers using sound-waves.
X-Ray
The doctor may decide to examine the heart, the body’s largest artery (aorta), and the lungs by taking a chest X-ray.
Stress Testing
This is used together with the EKG test. The test is conducted when one is doing an exercise to increase heart-rate. If the victim is not able to exercise, they are given a certain drug or medicine to raise the heart rate. This helps show the rhythm, blood pressure, and the electrical activity of the heart. This is necessary to determine the heart’s working potential as well as identify the hidden problems inside the heart.
Blood Test
This is a kind of test that is common to almost all diseases. It’s necessary to examine the level of protein, blood sugar, and cholesterol in the blood. This could help identify some heart disorders.
Electrophysiology Study
This test does the same job with the EKG test but takes the electrical pathways as well. It can be used to diagnose problems regarding the rhythm of the heart in order to find the best possible treatment.
During diagnosis, a Holter monitor and cardiac event recorder might be used. The following are the reasons why DHF patients may need such services.
Holter Monitoring Services
Holter monitoring services are necessary to check the rhythm of the heart in situations when the EKG test doesn’t give sufficient results. It’s worn within a period of one day (24 hours) to 3 days (72 hours) even when one is sleeping. All the patient’s heartbeats and heart rhythms are recorded on the device. The instrument is placed on the chest or attached on the patient’s belt using a tape or straps. The results are further used to diagnose the diastolic heart-failure condition along with several other tests.
Cardiac Event Recorder
This is a powerful device that medical specialists use to monitor a patient’s heart ECG (electrical-activity). In most circumstances, it is used when the sufferer has the symptoms. It records the heartbeats (slow and fast) and monitors situations when a person has specific symptoms such as fainting, dizziness, and chest pains. In addition, the specialist may use the device to check how one is responding to a particular medication. There is no known risk of using the equipment.
After diagnosis, the doctor decides on the best option to treat the patient.
Treatment Options of Diastolic Heart Failure
A doctor may use some of the following choices to treat a patient suffering from diastolic dysfunction.
Medication
This is the most common kind of treatment used when a patient has symptoms that can be managed without surgery or using other complex treatment methods. Common medications prescribed include HBP drugs, diuretics (eases swelling and promotes urination in order to reduce fluids in the body), beta-blockers, ARBs or ACE inhibitors, vasodilators, and calcium-channel-blockers.
Surgery
There is a higher possibility of undergoing surgery in situations when medication and other simple options don’t work. Angioplasty is the one most likely to be used by cardiologists. It’s used to repair damaged valves and/or blocked arteries.
Lifestyle Changes
This can help prevent and reduce most of the symptoms. It includes quitting smoking, exercising daily and regularly, maintaining a healthy weight, and eating a heart-healthy food. It’s also recommended to follow medications as administered by the doctor. Attending check-ups on a regular basis will also be helpful for patients with DHF.
Conclusion
In conclusion, DHF can be manageable especially when diagnosed early. The earlier the diagnosis, the easier it will be to treat the disease. Failure to identify and treat this condition early can lead to more serious and complicated problems such as anemia, kidney dysfunction, atrial fibrillation, stroke, cardiac cachexia, leg-venous stasis and also ulcers.