CHF questions-please help

[beth0277]

I had congestive heart failure caused by pre-eclampsia (high blood pressure) after I gave birth. It is rare, but does happen and most women make a full recovery shortly after with no other complications (other than risks of future pregnancies.) I just wanted to see if someone could help me understand something....Are there only 2 ways in which you can have heart failure, systolic & diastolic?

The reason I ask is because I know that I did not have systolic, my EF has been fine. I ask if that means it had to have been diastolic because on 2 echo's shortly after giving birth I had very mild diastolic dysfunction. In my non-medical thinking, I would think that it would be expected to have a small bit of diastolic dysfunction shortly after having heart failure, since my heart failure was not systolic. Does this reasoning make any sense?

My doctor expects my diastolic dysfunction to completely go away, and it is probably already back to normal. My BNP during my HF was 425 and a few weeks ago it was down to 7. Would you take this as a sign that my DD is already cleared up?

Any input would be greatly appreciated!

[kelea25]

I also had pre eclampsia with my first pregnancy in 2000 it was severe and i was 24 at the time.....i devolped CHF and was in icu for 3 days. it was also found that i had a thyroid dysfunction....My heart returned to normal and i did not have lasting damage...my heart healed the leaky valve that the high blood pressure caused..... i became pregnant again in 2003 and once again i devolped pre eclampsia a few days after my c section i ran a high fever and was put in icu with CHF....I was lucky that all my heart function returned to normal and I have low blood pressure... I do take a beta blocker due to my heart having occasional pvc's... all my echo have been normal... my doctor and i believe that i have pvcs due to anxiety due to all the emotional trauma.... crazy thing is i am thinking about having another baby.... i know i was lucky the first 2 times but not so sure if it will happen again...plus i am 33 now and the risk go up....i should probably just count my blessings and my two beautiful boys that are now 10 and 7...good luck with everything...

[kenkeith]

QUOTE: "I would think that it would be expected to have a small bit of diastolic dysfunction shortly after having heart failure, since my heart failure was not systolic. Does this reasoning make any sense?"

>>>> Not exactly the course of action.  

It is true, there can be heart failure with preserved normal systole function. For some insight, the ejection fraction (EF normal 55 to 75%) is preserved for a period of time with diastolic dysfunction.  With diastolic dysfunction the cardiac output is reduced as less blood is received from the lungs, but the same ejection fraction exists (but a decrease in CO), a decrease in CO can cause heart failure.... Systole failure happens when the contractions are weak (low EF) and the percentage of blood is pumped with each stroke.

Diastolic dysfunction happens as a result of the lower heart chamber doesn't relax sufficiently for the chamber to fill adequately and a study demonstrates the changes in myocardial relaxation velocity throughout pregnancy.  Eight weeks after delivery, all left ventricular systolic and diastolic functional parameters returned to normal values.

Conclusion: The natural volume overload in pregnancy leads to a reversible 'physiological' left ventricular hypertrophy, a short-term decrease in systolic function and a significant change in left ventricular diastolic function. With reduced volume, the heart returns to normal.  

Hope this helps, thanks for sharing.