Cardiac

Working With Doctors

Many PCPs and cardiologists are eager to skip screening for diastolic heart failure even in patients who realistically may have it, preferring to write the symptoms off as being caused by weight, stress, or anxiety. This leads to many cases of progressing diastolic heart failure every year. Don't be a statistic.

Stages of HF

Stage 1: Gasping for breath climbing stairs

Pseudonormal Diastolic HF

it is possible to have diastolic heart failure with a normal E/A ratio. This condition is classified as Grade II diastolic dysfunction, also known as pseudonormal. In this stage, the E/A ratio appears normal (typically between 0.8 and 1.5), but this is due to elevated left atrial pressure and reduced left ventricular compliance, which causes the E wave to be higher than normal. The normal appearance of the E/A ratio is misleading, and the true underlying diastolic impairment can be identified using additional tests such as a Valsalva maneuver, which causes the E/A ratio to reverse (E wave drops in amplitude), or by assessing the E/e' ratio, which is typically elevated. Structural heart disease, such as left atrial enlargement or left ventricular hypertrophy, is often present and serves as a key clue to the presence of pseudonormal filling patterns.

Early HF Symptoms

For years I had trouble walking distances without stopping to rest but thought of it as merely an inconvenience. And I'd had mildly swollen feet and ankles for years tho no one seemed excited about it.

i only noticed really getting out of breath during heavy exercise and getting winded when tying my shoe laces.

Shortness of breath, fatigue and struggling to walk flights of stairs without having to sit down (normally quite fit 5k a day and hit classes so seemed bizarre) mri caught heart failure

Advanced Routine Screening For Early Diastolic HF

Diastolic dysfunction is an indication of abnormal mechanical properties of the myocardium, characterized by slow or delayed myocardial relaxation, abnormal LV distensibility, and/or impaired LV filling.

cardiac magnetic resonance imaging (MRI) has the capability for differentiating between normal and abnormal myocardial relaxation patterns, and therefore offers the prospect of early detection of diastolic dysfunction. Although diastolic cardiac function can be assessed from the ratio between early and atrial filling peaks (E/A ratio), measuring different parameters of heart contractility during diastole allows for evaluating spatial and temporal patterns of cardiac function with the potential for illustrating subtle changes

https://pmc.ncbi.nlm.nih.gov/articles/PMC8706325/

NT Pro-BNP

If you are a BMI X or lower, the NT Pro-BNP blood test is very accurate at ruling out heart failure, including early diastolic heart failure. [Is this true? How about diastolic dysfunction?]

Echocardiogram

Traditional Echo with E/A Ratio

From Brave AI:

an E/A ratio greater than 2.5, combined with a deceleration time less than 140 milliseconds and an IVRT less than 50 milliseconds, is characteristic of grade 3 diastolic dysfunction (restrictive filling). In contrast, a reduced E/A ratio (e.g., <0.8) may indicate impaired relaxation or early diastolic dysfunction.