Diastolic heart failure, also known as heart failure with preserved ejection fraction (HFpEF), is a condition where the heart’s left ventricle becomes stiff and cannot relax properly. As a result, it fails to fill with enough blood between heartbeats, leading to inadequate blood flow to the body.

Unlike systolic heart failure—where the heart loses its ability to pump effectively—diastolic heart failure involves a preserved pumping function but impaired filling. Understanding this distinction is key to recognizing the condition and seeking timely medical help.

---

What Is Diastolic Heart Failure?

In a healthy heart, the ventricles fill with blood during the diastolic phase, the period when the heart relaxes between beats. In diastolic heart failure, the left ventricle becomes thickened or stiff, reducing its capacity to fill with blood. This leads to increased pressure in the heart and lungs, which in turn causes symptoms such as shortness of breath and fluid retention.

Although the heart’s ability to contract remains normal, the failure to relax properly impacts circulation and oxygen delivery throughout the body.

---

Causes of Diastolic Heart Failure

Several factors can lead to stiffening of the heart muscle and contribute to diastolic dysfunction:

• High blood pressure is a leading cause. Over time, it forces the heart to work harder, which thickens the heart muscle.
• Aging naturally reduces elasticity in the heart muscle, increasing the risk.
• Diabetes affects the heart’s structure and function, raising the likelihood of developing HFpEF.
• Obesity and metabolic syndrome are also strongly linked to diastolic heart failure.
• Coronary artery disease can reduce blood flow to the heart, leading to structural changes.
• Chronic kidney disease and other systemic illnesses may further worsen heart function.

By identifying and managing these conditions early, one can help delay or prevent the onset of heart failure symptoms.

---

Key Symptoms of Diastolic Heart Failure

Recognizing the symptoms of diastolic heart failure is essential for timely diagnosis and treatment. The most common symptoms include:

1. Shortness of Breath

Initially, this may occur only during physical exertion. However, as the condition progresses, even resting or lying flat can cause breathlessness, often due to fluid buildup in the lungs.

2. Fatigue and Weakness

Because the heart isn’t delivering enough oxygen-rich blood, individuals often feel unusually tired or weak—even after light activities.

3. Swelling (Edema)

Fluid may accumulate in the legs, ankles, feet, or abdomen, causing noticeable swelling. This occurs as pressure builds up in the blood vessels due to inefficient heart filling.

4. Rapid or Irregular Heartbeat

To compensate for reduced cardiac output, the heart may beat faster or develop arrhythmias such as atrial fibrillation.

5. Sudden Weight Gain

Unexplained weight gain may result from fluid retention and should be taken seriously, especially when combined with other heart failure symptoms.

---

Diagnosing Diastolic Heart Failure

Doctors use several tools to diagnose HFpEF:

• Echocardiogram is the primary test to evaluate the heart’s function and wall thickness.
• Electrocardiogram (ECG) checks for abnormal heart rhythms or previous heart damage.
• Chest X-ray may reveal fluid in the lungs or an enlarged heart.
• Blood tests, including BNP or NT-proBNP levels, can help assess heart strain.
• Stress tests may be used to examine how the heart performs under exertion.

Because symptoms can mimic other conditions, a thorough evaluation is necessary to confirm the diagnosis.

---

Currently, there’s no single cure for diastolic heart failure. However, treatment focuses on managing symptoms and underlying causes.

1. Lifestyle Modifications

• Regular physical activity can improve heart and lung efficiency.
• Low-sodium diets help prevent fluid retention and reduce blood pressure.
• Weight management reduces strain on the heart.
• Quitting smoking and alcohol supports overall cardiovascular health.

2. Medications

• Diuretics help relieve fluid buildup.
• Beta-blockers and ACE inhibitors may help control blood pressure and slow heart rate.
• Aldosterone antagonists can help in specific cases.

It’s essential to follow the prescribed treatment plan and attend regular checkups to monitor progress.

---

Living With Diastolic Heart Failure

Though chronic, diastolic heart failure can be managed effectively with proper care. Patients who stay consistent with treatment and lifestyle changes often experience an improved quality of life.

Moreover, early diagnosis and intervention can prevent complications such as hospitalization or progression to more severe forms of heart failure. Support from family, caregivers, and heart failure clinics can also play a significant role in long-term wellness.

---

Diastolic heart failure is a serious yet manageable condition. By understanding the causes, recognizing symptoms early, and adopting a heart-healthy lifestyle, individuals can take charge of their heart health. If you or a loved one experience unexplained fatigue, breathlessness, or swelling, don’t wait—consult a healthcare provider and take the first step toward effective care.