Diastolic heart failure means there’s a problem with your heart’s ability to fill with blood. It’s a type of congestive heart failure where your heart cannot work efficiently, leading to fluid overload in your body.
Congestive heart failure (CHF) is an umbrella term for heart failure that causes fluid buildup in the body.
- In diastolic heart failure, the muscles of the left ventricle stiffen and lose their ability to fill completely with blood between heartbeats. When this happens, the heart pumps less than normal amounts of blood into circulation. This is also known as heart failure with preserved ejection fraction, or HFpEF.
- In systolic heart failure, the left ventricle loses its ability to contract normally and pumps less than normal amounts of blood into circulation. This is also known as heart failure with reduced ejection fraction or HFrEF.
Heart failure is a serious, lifelong condition that requires medical attention. It’s also relatively common, with an estimated 6.5 million adults in the United States living with this condition.
This article takes a closer look at diastolic and congestive heart failure.
While heart failure is a serious condition, this doesn’t mean that your heart has suddenly stopped working, as is the case with cardiac arrest. Instead, this means that your heart is not pumping blood like it should. The extent of heart failure also depends on its type.
Diastolic heart failure
Diastolic heart failure is a type of left-sided heart failure that occurs when the heart’s left ventricle can’t relax enough to fill with enough blood. This causes a smaller amount of blood to be pumped out to your body.
When you have diastolic heart failure, your heart is still trying to pump blood, but it has to work harder to fulfill its basic functions.
Diastolic heart failure may also be referred to as heart failure with preserved ejection fraction (HFpEF). Ejection fraction is a measure of how much blood is pumped out of the left ventricle every time your heart muscle contracts.
Congestive heart failure
Congestive heart failure is a term for any type of heart failure with symptoms of congestion.
Congestive heart failure affects the pumping ability of your heart muscle and is chronic and progressive. When the ventricles of your heart can’t pump enough blood to your body, blood and other fluids can eventually back up inside your:
- lungs
- abdomen
- liver
- lower body
Does diastolic heart failure lead to congestive heart failure?
Diastolic heart failure is a type of congestive heart failure. Congestive heart failure is a generic term that refers to any type of heart failure that affects your heart’s ability to pump blood to the rest of your body.
The symptoms of diastolic heart failure are the same as congestive heart failure.
Some types of diastolic heart failure will have additional symptoms based on the underlying cause. For example, cardiac amyloidosis can have
- carpal tunnel syndrome
- lumbar spinal stenosis
- neuropathy (numbness or tingling in hands or feet)
- orthostatic hypotension (low blood pressure upon standing)
- easy bruising
- purple discoloration around eyelids
- enlarged tongue
In their early stages, neither diastolic nor congestive heart failure may cause any noticeable symptoms. However, as the heart pumps less blood to cells and tissues over time, you may experience:
- fatigue
- decreased concentration or memory difficulties
- shortness of breath, even while resting
- coughing
- wheezing
- noticeable weakness during everyday activities, such as walking
- difficulty exercising
- fluid retention, especially in your legs, feet, and abdomen
- coldness in your arms and legs
- decreased appetite
- nausea
- sudden weight gain or loss
Heart failure — whether diastolic or congestive — is treated with diuretics and management of the underlying conditions.
Doctors may also use medications to treat the underlying condition (such as high blood pressure) or to help relax blood vessels and improve overall heart function.
These medications may include:
- blood thinners for atrial fibrillation (AFib)
- blood pressure medications such as ACE inhibitors or calcium channel blockers
- diuretics to treat edema and high blood pressure (hypertension)
- statins for high cholesterol
- angiotensin-converting enzyme (ACE) inhibitors
- angiotensin receptor blockers (ARBs)
- angiotensin-receptor neprilysin inhibitors (ARNIs)
- beta-blockers
- diuretics
- sodium-glucose cotransporter-2 (SGLT-2) inhibitors
Additionally, a doctor may suggest lifestyle modifications to help complement treatment for heart failure. These include:
- regular exercise, which can help strengthen your heart muscle
- decreasing dietary salt intake
- quitting smoking if you smoke
- limiting or avoiding alcohol consumption
- stress management
A heart transplant may be necessary for refractory heart failure when other treatments don’t work. Refractory heart failure is the term doctors use when symptoms are persistent and severe enough to affect daily life, despite having medical therapy.
Heart failure treatment goals
The goal of treatment for both diastolic and congestive heart failure is to:
- help the heart function as efficiently as possible
- manage symptoms (such as fluid retention, fatigue, shortness of breath)
- prevent complications such as arrhythmias and cardiac arrest
Overall, about 50% of people with heart failure live 5 years or longer. A 2019 study found that the average survival rate dropped to
The exact outlook depends on the type and severity of heart failure you have, as well as your age and any underlying conditions and complications.
Also, experts consider diastolic heart failure difficult to treat compared with other types of heart failure. This is because many of the medications that are effective in systolic heart failure often don’t show the same results in diastolic heart failure.
There’s no cure for heart failure, but treatments can help reduce symptoms and help protect your heart from further strain. This includes diastolic heart failure, which is a type of congestive heart failure.
While diastolic heart failure affects the left side of your heart, and congestive heart failure is known for causing fluid buildup, both affect your heart’s ability to pump blood normally. This can lead to serious complications if left untreated.
Since heart failure doesn’t usually cause any obvious symptoms in its early stages, regular checkups with a doctor are key to detecting related conditions in a timely manner. However, if you’re experiencing possible heart-related symptoms, don’t wait till your next scheduled appointment, see a doctor right away.