Coronary artery disease and cardiomyopathy are among the most important causes

diastolic heart failure

Diastolic heart failure is the inability of the heart muscle to expand and relax and to fill the heart with enough blood needed to meet the demands of vital and important organs, such as the heart, brain, kidneys, and liver. 

What are the causes that lead to this type of heart disease?

 What are the signs of diastolic heart failure? 

What complications result from not getting the appropriate treatment early in the infection?

* Pulmonary congestion

* Your Health met Dr. Mamdouh Hussein Sadaqa Subhi, a consultant cardiologist at King Fahd General Hospital in Jeddah, to talk about the dimensions of this disease and ways to treat it. Stretching to fill the heart with enough blood. 

This leads to the difficulty of pumping blood and directing it from the left atrium to the left ventricle, and then to a decrease in the amount of blood that fills the left ventricle during the diastolic cycle. 

This leads to an increase in the pressure of the left ventricle, which results in a high rate of left atrial pressure, and this causes it to enlarge and eventually expand.

Dr. adds. Mamdouh Sobhi that the outcome of all these events and changes that occur in the heart will be reflected in the pulmonary veins that carry oxygen-saturated blood from the lungs to the left side of the heart 

where the pressure of the pulmonary veins increases, and then the pressure of the pulmonary capillaries increases, and this causes acute pulmonary congestion ( Acute Pulmonary Congestion) with the accumulation of fluid between the tissues of the lungs at first 

and eventually, this leads to its accumulation in the alveoli, causing acute pulmonary edema, which results in a reduction of the surface area required for the exchange of oxygen with carbon dioxide 

and leads to A decrease in the amount and concentration of oxygen in the blood and a rise in carbon dioxide, and this results in acute respiratory failure.

* Causes of diastolic heart failure

* First: myocardial hypertrophy, which results from many causes, the most important of which are:

High blood pressure and severe mitral valve stenosis.

- The presence of the genetic factor and the familial factor due to a defect in some genes, which leads to severe inflation in the ventricular septum, which is known medically as hypertrophic obstructive cardiomyopathy.

Finally, a congenital cause is the narrowing of the aorta descending into the chest.

Second: Restrictive Cardiomyopathy.

Third: coronary heart disease, which is one of the important causes of diastolic heart failure, such as unstable angina and partial and complete myocardial infarction.

Fourth: Diseases of the pericardial membrane, for example, acute cardiac tamponade, which usually occurs as a result of fluid accumulation between the layers of the pericardial membrane, and this in turn leads to high pressure of the pericardial membrane, which causes difficulty in the ability of the heart muscle to expand and relax

* Symptoms and complications

* Says Dr. Mamdouh Sobhi The most important symptoms of diastolic heart failure are shortness of breath when exerting effort and during rest, shortness of breath when relaxing, 

the need to use more than one pillow when sleeping, and concealment in the chest with a feeling of suffocation during sleep and awakening many times after sleep 

and all of these symptoms are due to pulmonary congestion. There is a set of symptoms that occur as a result of congestion of the liver and intestines, including abdominal cramps, nausea, vomiting, flatulence, and diarrhea. 

The patient may also complain of increased diuresis and frequent urination due to fluid reflux.

As for complications, in chronic cases of lack of oxygen concentration and quantity in the blood, constriction occurs in the main pulmonary artery, which causes high pressure in the pulmonary artery, resulting in a high rate of proper ventricular pressure with its enlargement, expansion, and failure.

The muscle of the right ventricle is the one that pumps the blood that is not saturated with oxygen to the lungs, and this results in regurgitation of the tricuspid valve 

and an increase in the pressure of the right atrium, with its enlargement and expansion, leads to a rise in the rate of pressure in the central vein.

This is the main reason for fluid reflux and accumulation in different areas of the body, the most important of which are the following:

Fluid accumulation in the feet, ankles, legs, and testicles.

Accumulation of fluid in the abdominal cavity causes ascites and ascites.

Accumulation of fluid between the layers of the pleural membrane surrounding the lungs causes pleural effusion.

In addition, fluid accumulates between the layers of the pericardial membrane that covers the heart, and this leads to pericardial effusion and a high rate of central venous pressure, and also leads to congestion and enlargement of the liver with elevated liver enzymes and also congestion in the intestinal wall and growth of the neck veins.

Other complications include cardiac arrhythmias, for example, atrial fibrillation due to left atrial wall dilatation, and atrial tremor due to right atrial wall dilatation.

* Treatment

* Says Dr. Mamdouh Sobhi The treatment of diastolic heart failure is based on scientific steps, as follows:

First: Treating the cause, for example, controlling high pressure with treatment, treating coronary artery disease through medical drugs, performing therapeutic cardiac 

catheterization by making balloon expansion with stent implantation in the coronary arteries, and treating severe stenosis of the mitral valve by changing the mitral valve with a heart operation. Open.

Second: Giving diuretics, as in the case of acute pulmonary congestion and fluid reflux in the body.

Third: Giving medicines that reduce the rate of high pressure in the heart chambers, such as varicose veins.

Fourth: Giving myocardial tonic drugs, as in the case of systolic heart failure associated with diastolic failure.

Fifth: Do not adding the Add salt to the food, and do not drink a lot of water and fluids in the event of swelling of the extremities and fluid reflux.

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