Diastolic dysfunction history and symptoms: Difference between revisions
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==Overview== | ==Overview== | ||
The classic symptoms of heart failure include [[dyspnea]], [[fatigue]], and [[fluid retention]]. Patients with heart failure present in different ways. Some patients present with [[exercise intolerance]] but show little evidence of [[congestion]] or [[edema]]. Other patients present with mild symptoms of [[edema]] and [[pulmonary congestion]]. | |||
==History and Symptoms== | ==History and Symptoms== | ||
The clinical manifestations of diastolic heart failure are as follows- | |||
* [[Ankle edema]] or [[swelling of the feet]] and legs | |||
* [[Dyspnea|Dyspnea on ordinary exertion]] or greater shortness of breath with usual activities | |||
* [[Fainting]] | |||
* [[Orthopnea]] or [[sleeping on pillows]] | |||
* [[Fatigue]] | |||
* [[Hemoptysis]] or frothy sputum | |||
* [[Paroxysmal nocturnal dyspnea]] or [[awakening at night with shortness of breath]] | |||
* [[Shortness of breath]] | |||
* [[Syncope]] or [[passing out]] | |||
* [[Weakness]] | |||
However, asymptomatic diastolic heart failure is more common. In a cross sectional survey of 2042 randomly selected residents of Olmstead County, Minnesota, systolic dysfunction was found to be frequently present in individuals without recognized CHF. Furthermore, diastolic dysfunction was often not accompanied by recognized CHF, and associated with marked increases in all-cause mortality<ref name="pmid12517230">{{cite journal| author=Redfield MM, Jacobsen SJ, Burnett JC, Mahoney DW, Bailey KR, Rodeheffer RJ| title=Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic. | journal=JAMA | year= 2003 | volume= 289 | issue= 2 | pages= 194-202 | pmid=12517230 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12517230 }} [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12954043 Review in: ACP J Club. 2003 Sep-Oct;139(2):51] </ref>. | |||
The manifestations of overt systolic and diastolic heart failure is nearly similar. However, patients with diastolic dysfunction show poor response to certain stresses on the heart, - | |||
* [[Tachycardia]], increased heart rate would hamper proper and complete filling of left ventricle. | |||
* [[Hypertension]], especially if it is acute in onset or refractory to treatment increases the stress on the walls of the ventricle, which in turn leads to [[hypertrophy]] and impaired filling. | |||
* [[Atrial fibrillation]] leads to poor coordination between atrial and ventricular contraction and contributes to further reduction in filling. | |||
* Acute ischemia, leads to diastolic dysfunction which increases left atrial pressure and causes [[pulmonary edema]]. | |||
==Physical examination== | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 02:19, 21 October 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The classic symptoms of heart failure include dyspnea, fatigue, and fluid retention. Patients with heart failure present in different ways. Some patients present with exercise intolerance but show little evidence of congestion or edema. Other patients present with mild symptoms of edema and pulmonary congestion.
History and Symptoms
The clinical manifestations of diastolic heart failure are as follows-
- Ankle edema or swelling of the feet and legs
- Dyspnea on ordinary exertion or greater shortness of breath with usual activities
- Fainting
- Orthopnea or sleeping on pillows
- Fatigue
- Hemoptysis or frothy sputum
- Paroxysmal nocturnal dyspnea or awakening at night with shortness of breath
- Shortness of breath
- Syncope or passing out
- Weakness
However, asymptomatic diastolic heart failure is more common. In a cross sectional survey of 2042 randomly selected residents of Olmstead County, Minnesota, systolic dysfunction was found to be frequently present in individuals without recognized CHF. Furthermore, diastolic dysfunction was often not accompanied by recognized CHF, and associated with marked increases in all-cause mortality[1].
The manifestations of overt systolic and diastolic heart failure is nearly similar. However, patients with diastolic dysfunction show poor response to certain stresses on the heart, -
- Tachycardia, increased heart rate would hamper proper and complete filling of left ventricle.
- Hypertension, especially if it is acute in onset or refractory to treatment increases the stress on the walls of the ventricle, which in turn leads to hypertrophy and impaired filling.
- Atrial fibrillation leads to poor coordination between atrial and ventricular contraction and contributes to further reduction in filling.
- Acute ischemia, leads to diastolic dysfunction which increases left atrial pressure and causes pulmonary edema.
Physical examination
References
- ↑ Redfield MM, Jacobsen SJ, Burnett JC, Mahoney DW, Bailey KR, Rodeheffer RJ (2003). "Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic". JAMA. 289 (2): 194–202. PMID 12517230. Review in: ACP J Club. 2003 Sep-Oct;139(2):51