Diastolic Heart Failure Diagnosis Criteria

Heart failure represents the final stage of various heart diseases and is categorized into systolic heart failure and diastolic heart failure. The diagnostic criteria for diastolic heart failure are primarily outlined as follows:

Common Symptoms and Physical Signs

Patients may exhibit symptoms such as shortness of breath due to pulmonary congestion or signs of systemic congestion including jugular vein distention, positive hepatojugular reflux, enlarged and congested liver, pleural effusion, and ascites. These manifestations are key indicators that support the clinical suspicion of diastolic dysfunction.

Left Ventricular Ejection Fraction

In diastolic heart failure, the left ventricular ejection fraction (LVEF) is typically normal or only mildly reduced, but remains above 45%. This is crucial in differentiating diastolic heart failure from systolic heart failure, where the LVEF is significantly reduced.

Echocardiographic Findings

An echocardiogram is essential for confirming the diagnosis. It may reveal impaired ventricular relaxation, such as a mitral inflow velocity pattern where the E wave is less than or equal to the A wave (E ≤ A), abnormal wall motion, and other indicators of diastolic dysfunction.

Management and Treatment Approaches

While there is no cure for diastolic heart failure, treatment focuses on managing underlying causes and alleviating symptoms. Medications such as beta-blockers (e.g., metoprolol, bisoprolol) and calcium channel blockers (e.g., diltiazem) are often prescribed to slow heart rate, reduce myocardial oxygen demand, and improve diastolic function. Addressing contributing factors like hypertension, diabetes, and coronary artery disease is also vital in optimizing patient outcomes.