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diastolic dysfunction = heart failure?
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diastolic dysfunction = heart failure?

I recently had an echocardiogram and was diagnosed with "moderate left ventricular diastolic dysfunction, grade 2 ".  Does the mean i have or will eventually get HF? I have an appt with a cardiologist in January and just wondering if anyone else out there with similar diagnosis can shed some light on this.
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Avatar_f_tn
Hi,
     Diastolic dysfunction, when not managed properly can lead to heart failure. Grade 2 diastolic dysfunction also known as pseudonormal filling dynamics leads to elevated left atrial pressures and causes symptoms similar to heart failure. If you are asymptomatic, then the goal of treatment is treating the underlying conditions like high blood pressure or diabetes which lead to diastolic dysfunction. Diastolic dysfunction is a chronic condition and can be handled by the patient without any medical treatment.
Diuretics, calcium channel blockers and ACE inhibitors are usually employed in treatment. Best
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Avatar_m_tn
Thanks for ur quick reply Dr. Veena, appreciate it! Quick question, so if i do get the underlying condition under control will my diastolic dysfunction not get any worse which would save me from getting HF? Also, u say that this causes symptoms similar to HF but is not HF, so how do you clinically diagnose HF? Thanks
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Avatar_m_tn
ok, i had some time to think about this and would like an honest and blunt answer to this question, if there is one. You did mention that it is a chronic condition, so does this mean it is inevitable for me to develop a more severe form of HF some time down the road? even if the underlying cause were to be normalized. So the only question would be how much time till then?
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Avatar_f_tn
Hi,
     By treating the underlying conditions that lead to diastolic dysfunction, the severity of diastolic dysfunction is not worsened and hence does not progress to heart failure. Primarily if you are asymptomatic, main goal of treatment should be managing the underlying conditions. If left untreated diastolic dysfunction does lead to heart failure and this can be diagnosed by echocardiogram, ECG, tread mill test and chest x-ray. Hope this helps. Best.

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367994_tn?1304957193
For some insight, DD is a condition that involves the filling phase of the heartbeat cycle.  The pathology of DD is the left ventricle walls become thickened and during the filling phase the rigidity of the walls compromises the filling capacity.

We know that heart failure is the result of an insufficient amount of blood pumped into circulation and the measurement is the percent of blood pumped with each stroke.  So one can have DD and the measurement of EF doesn't change because the heart is pumping the same percentage from a decreased chamber capacity.  If and when the decreased capacity is severally reduced, the cardiac output will not be able to meet the system's demand for oxygenated blood....that would be heart failure.
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Avatar_f_tn
I was also told I have Concentric left ventricular hypertrophy and diastolic dysfuncion my doctor has not refered me to a heart doctor just gave me medican Lasix. I do not and have never had high blood pressure so I don't know what is going on but I am going to request to see a heart specialist.
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Avatar_f_tn
It is possible that you have a true form of Hypertrophic Cardiomyopathy (HCM) which can be a primary issue with the heart or a secondary issue caused by other problems such as high blood pressure. You NEED to see a specialist who deals with HCM to find out for sure. I can hardly believe your doctor has not referred you to a center that deals with this problem. Calcium channel blockers are one of the main drug groups that are used top treat this problem, ssometimes there are blockages or obstructions which surgery is indicated for. This would be called Hypertrophic Obstructive Cardiomyopathy (HOCM). The fact that you have a concentric form of the diease is rarer as all of the walls, in that case, are thickened. Usually only one wall has the thickening: the septal wall which is the wall that divides the right and left ventricles. HCM is a form of distolic heart failure and is completely different than systolic heart failure which is the problem for which most patients take lasix for. Sometimes patients go into the 'burn out stage' of HCM and develop systolic heart failure; this is rare though. Some, in fact, most cases like your where there are no other systemic issues like HBP, the disease is genetic and it sounds like you may have a genetic issue going on here. Cleveland Clinic and Mayo Clinic are two of the top centers for dealing with this form of heart disease so my advice would be to go to one of these clinics. It would be well worth the trip! Take care
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Avatar_n_tn
hi doctor veena.  i;ve had open heart surgery to repair pulm. valve as a child in 1966. no smoke/drink, but now am having serious breathing issues when swimming (intense).  2010 angiogram showed grade2 d/d and mild pulmonic regurg.  recently admitted to hospital for extreme breathlesness...
could exercise be damaging my heart instead of making me better?
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Avatar_f_tn
i have been dx with grade 1 dysfunction. I am about 80 lbs overweight and i have DOE, SOB and fatigue. Please give me guidance on how to proceed. I am in a catch 22 with how to lose weight to lessen the causation if i am so SOB its difficult to exercise.
Jacki, 48
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