Diastolic Dysfunction: Grades, Pathology, Significance and Echocardiographic Findings and Treatment Options

This chapter deals with disturbance in the filling phase of the Ventricles, especially the Left Ventricle. In severe cases, this filling decrease may lead to diminished perfusion of the tissues resulting in Heart Failure. This Heart Failure is called Heart Failure with Preserved Ejection Fraction, if the Systolic Function is unaffected (HFpEF). If the Diastolic Dysfunction is prolonged and severe, it may lead to Systolic Dysfunction as well, which is called Heart Failure with Reduced Ejection Fraction (HFrEF). The grades (4 in number) of Diastolic Dysfunction, how to identify them through altered measurements, the causes of this disfunction, the hemodynamic changes, the role of Echocardiography (2D, M Mode, Doppler), the associated findings, the symptoms and signs the patients present with and the treatment options are discussed in detail. The role of Valsalva maneuver in recognizing the grades is discussed. How the Athlete’s Heart differs from the normal heart is mentioned. The role of Mitral Valve Inflow tracing and Tissue Doppler Imaging (TDI) to differentiate the grades is analyzed. The role of Pulmonary Vein Flow tracing and Velocity of Propagation (Vp) slope of color M mode to recognize LVEDP increase is also mentioned. After reading this chapter, the reader will have a good idea of the various aspects of Diastolic Dysfunction.