The heart is the center of the circulatory system, and its main job is to provide nutrient-rich blood and oxygen to all the vital tissues of the body. It is divided into four chambers—two on the right side and two on the left side. Show
The right atrium receives oxygen-poor blood from two major veins, the inferior and superior vena cava, and sends it to the right ventricle, which pumps it to your lungs via the left and right pulmonary arteries. Here, it picks up oxygen and gets rid of carbon dioxide. Verywell / Jessica Olah Oxygen-rich blood from the lungs enters the left ventricle, where it is pumped to the rest of the body by the aorta, the largest artery. The heart’s pumping process is called the cardiac cycle. On average one cardiac cycle pumps 5.6 liters (L) of blood throughout the body. The left ventricle is the chamber that is responsible for pumping blood from the heart to the rest of the body. Dysfunction of the left ventricle leads to two types of heart failure: systolic and diastolic. This article details the differences and similarities of systolic and diastolic heart failure. How Common Is Heart Failure?Heart failure is common in the United States, with over 6 million people living with this condition. Additionally, nearly 1 million new cases are diagnosed each year. Fortunately, medical advances have made it possible to manage heart failure. Systolic and Diastolic Heart Failure DefinedBoth sides of the heart are prone to dysfunction, but heart failure on the left side is more common.
The most common culprits of left-sided heart failure are:
While the right side of the heart is more commonly affected by:
Systolic Heart FailureSystolic heart failure occurs when the left ventricle loses its ability to contract. In people with systolic heart failure, blood fills the left ventricle at normal levels, but it cannot be pumped in adequate amounts to support bodily functions. For this reason, systolic heart failure is also called heart failure with reduced ejection fraction (HFrEF). If the body’s tissues are deprived of oxygen, organ failure may ensue. The most common causes of systolic heart failure are:
Diastolic Heart FailureDiastolic heart failure occurs when the left ventricle loses its ability to expand due to stiffness. The heart chamber also is unable to fill with enough blood during the resting periods of the cardiac cycle. As a result, there is less blood available to pump out of the heart. Because the heart does not lose the ability to contract, diastolic heart failure is also called heart failure with preserved ejection fraction (HFpEF). As you get older, the heart and blood vessels become less elastic, increasing your risk of developing diastolic heart failure. Other causes of diastolic heart failure include:
Symptoms and DiagnosisSymptomsNearly 3% of Americans experience heart failure, and it is becoming more common in those over 65 years old. Knowing the signs and symptoms of heart failure can help you get an early diagnosis, which can be lifesaving. If you experience any of the following symptoms of heart failure, seek immediate medical attention:
The following is the New York Heart Association's classification system, which is the simplest and most widely used method to gauge symptom severity: Class I
Class II
Class III
Class IV
DiagnosisDuring the initial evaluation of systolic or diastolic heart failure your healthcare provider or another healthcare professional will take a detailed history and perform the following:
Computed tomography (CT), magnetic resonance imaging (MRI), and nuclear scanning are other imaging tests that may also be used to look at the heart. Diagnosis of systolic heart failure is based on the following:
Diagnosis of diastolic heart failure is based on the following:
Diagnosis of diastolic heart dysfunction can also be measured invasively, by inserting a catheter, or noninvasively, by using Doppler imaging (ultrasound) techniques. ComplicationsSystolic and diastolic heart failure is a progressive condition that can lead to life-threatening complications if left untreated. The most common complications include:
Risk Factors and PreventionAs previously mentioned, heart failure is more common as you age, but many other factors put you at risk. Fortunately, many of them can be modified. The primary risk factors for diastolic heart failure are:
Several other factors may contribute to developing systolic heart failure, including:
Preventing heart failure is the key to living a happy and heart-healthy life. We now know that heart disease may begin as early as adolescence, even though we may not feel symptoms until much later in life. So, the sooner you adopt healthful behaviors, the better off you will be. The American Heart Association and the U.S. Preventive Services Task Force recommend the following habits:
TreatmentIn most people, heart failure is a chronic condition that requires lifelong treatment. Most treatments are geared toward slowing down the progression of your heart failure and managing your symptoms. Whether you have systolic or diastolic heart failure the key is to follow a treatment regimen that includes a combination of diet and lifestyle changes, medicines, and sometimes a device to protect your heart from abnormal rhythms. The same lifestyle changes necessary for prevention also help manage your symptoms if you have heart failure, including:
Treatment Options for Systolic Heart FailureAdequate treatment of systolic heart failure may require the use of one or several medications, including:
Treatment Options for Diastolic Heart FailureWhile medicine hasn't been proven to benefit patients with diastolic heart failure, diuretics are commonly used to manage heart failure symptoms. They work by removing excess fluid from the body and slowing the heart down so it has more time to fill. The best way to manage diastolic heart failure is to treat its underlying causes, such as hypertension, diabetes, or coronary artery disease. Frequently Asked QuestionsWhat is the life expectancy of someone with systolic or diastolic heart failure?The prognosis of systolic and diastolic heart failure depends on many factors including:
Survival rates in patients with heart failure are 75.9% at one year, 45.5% at five years, and 24.5% at 10 years, compared to 97%, 85%, and 75% in the general population, respectively. Is it worse to have systolic or diastolic heart failure?Many studies have concluded that systolic heart failure has a worse 10-year prognosis, but systolic and diastolic heart failure both carry a grim diagnosis, which is why it is important to lead a heart-healthy life. Is systolic or diastolic heart failure more common?Compared with systolic heart failure, diastolic heart failure is seen more often in the elderly and women. More research needs to be done on the prevalence of systolic and diastolic heart failure in different racial and ethnic groups. SummarySystolic heart failure occurs when the left side of the heart becomes too weak to squeeze normal amounts of blood out of the heart when it pumps. Diastolic heart failure occurs when the left side of the heart is too stiff to relax and fill normally with blood. What is the pathophysiology of systolic and diastolic heart failure?Pathophysiology of Systolic and Diastolic Heart Failure
Diastolic heart failure occurs when there is increased resistance to the diastolic filling of part or all of the heart but systolic function (ejection fraction > 45%) is still preserved.
Can you have combined systolic and diastolic heart failure?Abstract. There is increasing recognition that disorders of both left ventricular systolic and diastolic function can result in congestive heart failure. As such, consideration of both the filling and emptying characteristics of the left heart is needed to evaluate the hemodynamic abnormalities present in this syndrome ...
Do both systolic and diastolic heart failure have a reduced cardiac output?Overall, the changes in cardiac function associated with heart failure result in a decrease in cardiac output. This results from a decline in stroke volume that is due to systolic dysfunction, diastolic dysfunction, or a combination of the two.
What is the pathophysiology of chronic heart failure?Heart failure is a medical condition characterized by reduced cardiac output (CO) and increased venous pressure, associated with underlying molecular changes and subsequent damage to and death of cardiac muscle cells. The body has its own ways of increasing lowered CO, which together make up the neurohumoral response.
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