Do you sometimes feel short of breath even after doing a little work? Or do your legs swell and you feel tired? Perhaps behind these things is the condition we are talking about today called `Diastolic Dysfunction`. Don't worry, we will talk about this simply, in a way that you can understand.
What is Diastolic Dysfunction? Let's understand it simply.
Okay, first let's take a look at how our heart works. Did you know that our heart is like a pump? This pump has two main parts. One is the two chambers at the top of the heart, which we call the `Atria` . The other is the two chambers at the bottom of the heart, which we call the `Ventricles` .
Now, when the heart beats, that is, when there is a `Heartbeat` , two main things happen:
1. Diastole: This is the first part of the heartbeat. What happens here is that the lower chambers of the heart (the ventricles) relax a little, like a balloon getting ready to inflate. Then blood from the upper chambers (the atria) fills these chambers. Simply put, this is the time when the heart fills with blood.
2. Systole: After the ventricles are filled with blood, they contract strongly, or contract. The blood is then pumped out of the heart, to the lungs, and into the aorta, the main blood vessel that carries blood to the entire body.
Now do you understand what ``Diastole`` is? Diastolic Dysfunction is when ``Diastole``, the time when the lower chambers (cells) of the heart should relax to fill with blood, doesn't happen properly. To be precise, the lower chambers of your heart become a little stiff and don't relax properly. What happens then? Those chambers can't fill with blood properly. When that happens, pressure starts to build up inside the heart.
Think about it, for a sponge to absorb water, it can't be squeezed, it has to be a little loose. In the same way, for the chambers of the heart to fill with blood, they have to be well relaxed.
If this condition worsens, it can lead to a condition called ``Diastolic Heart Failure`` , which means the heart stops working. Then, fluids such as water can accumulate in places like the lungs, abdomen, and legs.
What is the difference between Diastolic Dysfunction and Diastolic Heart Failure?
These two are not the same, but they are related to each other. ``Diastolic Dysfunction`` is when the problem of the lower chambers of the heart starting to relax. When this becomes a little more severe, meaning the lower chambers of the left side of the heart become stiff, and it comes with other symptoms of heart failure, we call it ``Diastolic Heart Failure`` . This is a type of heart failure that affects the left side.
A person with ``Diastolic Heart Failure`` may experience symptoms such as:
- Fatigue: Feeling tired even just being there.
- Swelling of the legs: Especially the ankles.
- Nausea and loss of appetite: You don't feel like eating, and you may feel nauseous.
- Difficulty breathing (Dyspnea): Difficulty breathing even when doing simple tasks, sometimes even while sleeping.
- Weight gain: Water retention can cause sudden weight gain.
Who is more likely to develop this condition? What are the risk factors?
Actually, anyone can develop ``Diastolic Dysfunction``. However, some people are at a slightly higher risk. Let's see who they are?
- People over 70 years of age: The risk of this condition increases as you get older.
- People who are not physically active: Lack of exercise and being sedentary can affect this.
- People who smoke or use tobacco products.
Also, the risk is even higher if you have health problems such as:
- If your body mass index (BMI) is 30 or higher (which means you are obese).
- If you have heart muscle disease (`Cardiomyopathy`) .
- If you have diabetes .
- If you have high blood pressure (High Blood Pressure / Hypertension) .
- If you have coronary artery disease .
- If you have sleep apnea .
How does Diastolic Dysfunction affect the body?
Imagine, because the lower chambers of the heart are not filling with blood properly, the upper chambers have to work harder to pump blood. This increases the pressure inside the heart. What happens because of this pressure?
- The pressure in the blood vessels in the lungs increases and fluid can accumulate. This is when breathing difficulty occurs.
- The pressure in the blood vessels in the stomach and legs increases, and fluid can accumulate there as well. This can cause things like loss of appetite and swelling in the legs.
Over time, this condition, called ``Diastolic Dysfunction``, can develop into ``Diastolic Heart Failure``. It is also a major cause of pulmonary hypertension . It can sometimes be associated with an irregular heartbeat called ``Atrial Fibrillation`` .
The condition that many people with ``Diastolic Heart Failure`` have is called HFpEF (``Heart Failure with Preserved Ejection Fraction``) . Simply put, the amount of blood pumped by the heart (we call it ``Ejection Fraction``) is normal, but it shows signs of heart failure.
How common is this condition?
Diastolic dysfunction is a very common condition among the elderly. According to some medical experts, about half of people over the age of 70 may have some degree of diastolic dysfunction. However, it is not as common among children and people under the age of 70.
What are the symptoms of Diastolic Dysfunction?
Many people have mild levels of ``Diastolic Dysfunction`` . You may feel a little short of breath with light exertion, such as climbing stairs. However, as the condition progresses, breathing becomes more difficult and symptoms of ``Diastolic Heart Failure`` may develop.
What are the causes of Diastolic Dysfunction?
There are several main reasons for this. The risk factors we discussed earlier are also related to this.
- Coronary Artery Disease: Blockage of the arteries that supply blood to the heart.
- Diabetes.
- High blood pressure (`High Blood Pressure / Hypertension`).
- If you have had previous heart attacks.
- Sleep apnea.
How to diagnose this condition? (Diagnosis)
If your doctor suspects you have this condition, they will likely refer you for an echocardiogram ( also known as an "echo test") .
An echo test is like an ultrasound scan. It looks at how well your heart is pumping blood, how well your heart valves are working, how thick the walls of your heart chambers are, and how well they relax. This is very important to find out if you have diastolic dysfunction.
Is Diastolic Dysfunction graded according to severity? (Grades)
Yes, doctors classify this condition according to its severity. It's called "Grades".
- Grade I: This is a mild weakness in the heart's ability to relax. This is usually seen in people over 60 years of age.
- Grade II: The pressure on the left side of the heart is slightly increased.
- Grade III: The pressure in the left side of the heart is significantly increased.
- Grade IV: This is severe heart failure. The pressure on the left side of the heart is very high.
What are the treatments for Diastolic Dysfunction?
The best thing is, there are treatments for this condition. There are several possible treatments:
1. Lifestyle changes: This is very important.
- If you smoke, stop.
- Reducing salt (sodium) in foods.
- Regular exercise (especially aerobic exercise like walking and cycling).
- Your doctor may also refer you to a cardiac rehabilitation program , which can help improve your heart health.
2. Types of medicines:
- Diuretics (or "water pills"): These help reduce the amount of unnecessary fluid that has accumulated in the body.
- If you have other diseases, such as high blood pressure or diabetes, you may be given separate medications to control them .
3. Left Ventricular Assist Devices (LVADs): These are small devices that are surgically implanted in the heart to help the heart pump blood. They are usually used in severe cases of Diastolic Heart Failure, especially when the heart's ability to pump blood (Systolic Function) is also severely reduced.
4. Heart Transplant: This is only considered in very severe cases, when no other treatment has worked. Most people can manage this condition with lifestyle changes and medication.
Can Diastolic Dysfunction be prevented?
Yes, it is possible to a large extent! Following heart-healthy habits can reduce this risk. What are those habits?
- Maintain a healthy weight for your height, age, and gender.
- Avoid tobacco and alcohol. Limit caffeine (tea, coffee) consumption.
- Eat a balanced diet rich in fruits, vegetables, legumes, whole grains, healthy fats (e.g. olive oil, avocado), and lean protein (fish, chicken).
- Do at least 150 minutes of aerobic exercise (such as brisk walking, running, swimming) per week.
- If you have other medical conditions (such as diabetes, high blood pressure), follow your doctor's instructions and take your prescribed medications exactly as prescribed.
- Limit the consumption of saturated fats, salt, and refined sugar.
- Manage stress (through meditation, yoga, talking to a trusted person, etc.).
- Get at least 7-8 hours of good sleep at night.
What happens if you have diastolic dysfunction? What can you expect?
If left untreated, diastolic dysfunction can gradually worsen and lead to heart failure. However, many people can manage the condition well and lead normal lives with lifestyle changes and medication.
The most important thing is that if you have this condition, you go for regular medical checkups and follow your doctor's instructions exactly. Then, your doctor can monitor your condition and add more treatments if necessary.
What questions should you ask your doctor?
If you have or suspect you have diastolic dysfunction, you can ask your doctor these questions:
- What is the most likely cause of these symptoms I have?
- What are the early symptoms of ``Diastolic Dysfunction``?
- What tests should I do to accurately diagnose this condition?
- What are the treatment options for ``Diastolic Dysfunction``?
- What changes should I make in my lifestyle to reduce the risk of this condition getting worse?
What is the main cause of Diastolic Dysfunction?
Uncontrolled high blood pressure is the most common and leading cause of diastolic dysfunction and diastolic heart failure.
How long can you live with Diastolic Dysfunction?
There is good news! People with ``Diastolic Dysfunction`` who do not have coronary artery disease can live as long as a healthy person of the same age. However, if you have ``Diastolic Dysfunction`` along with other heart conditions (such as coronary artery disease, systolic heart failure), the situation may be a little different. That is why it is so important to get proper treatment and follow your doctor's advice.
Take-Home Message
Diastolic dysfunction is when the lower chambers of the heart do not relax properly and fill with blood. This increases the pressure inside the heart, which can eventually lead to heart failure.
But don't worry! This is a condition that can be well controlled with good lifestyle changes, medication if necessary, and regular medical monitoring. Take care of your heart and live a healthy life. If you have any concerns, don't hesitate to talk to your doctor.
` Diastolic dysfunction, heart disease, heart failure, shortness of breath, high blood pressure, diabetes, heart failure
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