Congestive heart failure with normal ejection fraction. A different mechanism requiring different therapy.
Clinicians must remain undaunted when history, physical examination, and chest radiography suggest congestive heart failure but left ventricular systolic function is normal. Many of these patients have diastolic dysfunction, and standard therapy for left ventricular systolic dysfunction is often ineffectual or detrimental. Noninvasive testing is subject to many pitfalls but may confirm a clinical suspicion and provide indications to treat or to proceed with invasive testing. In the absence of clinical signs and symptoms of congestive failure, however, abnormal diastolic indexes should not be interpreted as diagnostic of diastolic dysfunction and are not an indication to treat.
Section of Cardiology, Medical College of Georgia, Augusta 30912-3105.
W B
WB
Rogers
L M
LM
Prisant
J L
JL
Houghton
M J
MJ
Frank
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis; D006333:Heart Failure / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D013318:Stroke Volume
D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers