By Dr. Johan Rizwal Ismail, Consultant Cardiologist & Internal Medicine
Your heart has four chambers: the right and left atria (upper chambers) and the right and left ventricles (lower chambers).
The right ventricle pumps blood to the lungs, while the left ventricle pumps oxygen-rich blood to the rest of the body. The left ventricle is the strongest chamber, as it is responsible for supplying blood throughout the body.
Blood pressure is measured using two numbers:
Systolic pressure: the force when the heart contracts and pumps blood
Diastolic pressure: the pressure when the heart relaxes between beats
Diastolic heart failure occurs when the left ventricle becomes stiff and cannot relax properly between heartbeats. This reduces its ability to fill with blood.
As a result, the heart may not pump enough blood to meet the body’s needs, even though its pumping strength may appear normal.
Diastolic heart failure is often linked to conditions that cause the heart muscle to become stiff or less flexible over time.
Common causes and risk factors include:
Atrial fibrillation (AFib): An irregular heart rhythm that affects how the heart fills with blood
Coronary artery disease: Narrowed or blocked arteries that reduce blood flow to the heart
Diabetes: Long-term high blood sugar levels that can damage blood vessels and the heart
High blood pressure: Increases strain on the heart, leading to thickening and stiffness of the heart muscle
Sleep apnoea: Repeated interruptions in breathing during sleep that affect oxygen levels and heart function
Obesity: Places additional strain on the heart and is often linked to other risk factors
Chronic kidney disease: Can affect fluid balance and increase strain on the heart
Other heart conditions: Such as cardiac amyloidosis or other infiltrative heart diseases that affect the structure of the heart muscle
When the left ventricle becomes stiff, it cannot relax properly and does not fill with enough blood. As a result, less blood is pumped to the body.
Common symptoms include shortness of breath, fatigue, swelling in the legs and reduced ability to exercise:
Shortness of breath: Especially during physical activity or when lying flat
Fatigue: A persistent feeling of tiredness or reduced energy levels
Swelling (oedema): Commonly affecting the legs, ankles, feet or abdomen
Reduced ability to exercise: Becoming easily tired during normal activities
Persistent cough or wheezing: May be worse at night or when lying down
Dizziness or light-headedness
Frequent urination: Particularly at night
To diagnose diastolic heart failure, your cardiologist will assess your symptoms, medical history and overall heart function.
This may include:
Physical examination: Listening to your heart and lungs using a stethoscope
Blood tests: To check for underlying conditions and markers of heart stress
Chest X-ray: To assess heart size and fluid in the lungs
Electrocardiogram (ECG): To evaluate heart rhythm and electrical activity
Echocardiogram: A key test that uses ultrasound to assess heart structure and function
Exercise stress test: To evaluate how your heart performs during physical activity
Treatment focuses on managing symptoms, improving heart function and addressing underlying conditions.
Common treatment approaches include:
Managing blood pressure to reduce strain on the heart
Medications, such as diuretics, to help reduce fluid build-up
Lifestyle changes, including a heart-healthy diet, regular physical activity and weight management
Treating underlying conditions, such as diabetes, sleep apnoea or coronary artery disease
Diastolic heart failure and heart failure with preserved ejection fraction (HFpEF) are two types of left-side heart failure. While there is no cure, symptoms can often be effectively managed with appropriate treatment and lifestyle adjustments.
Many individuals with diastolic heart failure are able to maintain a good quality of life with proper care. The risk of developing this condition increases with age and in those with conditions such as high blood pressure or diabetes.
Diastolic and systolic heart failure affect how the heart functions, but in different ways:
Diastolic heart failure: The heart muscle becomes stiff and cannot relax or fill with blood properly
Systolic heart failure: The heart muscle becomes weak and cannot pump blood effectively
You should seek medical attention if you experience symptoms that may suggest heart failure.
Seek medical advice if you have:
Shortness of breath or breathlessness during activity or at rest
Swelling in the legs, ankles, feet or abdomen
Persistent fatigue or reduced ability to carry out daily activities
Chest discomfort or pressure
Early evaluation can help detect heart conditions and prevent complications.
Diastolic heart failure may develop gradually and is often linked to conditions such as high blood pressure or diabetes.
If you experience symptoms such as shortness of breath, fatigue, swelling in the legs or reduced exercise tolerance, it is important to seek medical evaluation.
At Prince Court Medical Centre, our cardiologists provide comprehensive care, from accurate diagnosis to personalised treatment for heart conditions.
Book an appointment today with our team of cardiologists to better understand your symptoms and receive appropriate care.Be the first in line to receive the latest updates and promotions, delivered directly to your inbox.
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