Diastolic Heart Failure

Systolic and Diastolic Heart Failure

Heart failure occurs when the heart cannot pump enough blood for the body due to a weakened or damaged heart. The heart 's pumping action moves oxygen-rich blood as it travels from the lungs to the left atrium, then on to the left ventricle, which pumps it to the rest of the body. The left ventricle supplies most of the heart 's pumping power, so it 's larger than the other chambers and essential for normal function. (American Heart Association). In left-sided or left ventricular heart failure, the left side of the heart must work harder to pump the same amount of blood. There are two types of left-sided heart failure: systolic heart failure and diastolic heart failure. Heart failure can arise from

Renin-angiotensin-aldosterone (RAA) and adrenergic antagonists improve symptoms and the quality of life while decreasing mortality. No such therapies have been discovered for diastolic heart failure; however, angiotensin receptive blocking agents have the potential to decrease morbidity in the patients, but not the mortality. (Chatterjee 574). Although patients with diastolic heart failure have a lower annual mortality rate than patients with systolic heart failure, they have a higher rate than the general population. They also have hospitalization rates similar to those of patients with systolic heart failure. These observations emphasize diastolic heart failure as an important contributor to morbidity, mortality, and health care costs, and highlight the need for further research and clinical trials examining this condition. (Chatterjee 572). Differentiating between systolic and diastolic dysfunction is essential because their long-term treatments are. The treatments of choice in patients with systolic dysfunction are ACE inhibitors, digoxin, diuretics and beta blockers. In patients with diastolic dysfunction, the cornerstones of treatment depend on the underlying

Pharmacologic treatments for diastolic heart failure and systolic heart failure are similar in the fact they both should include an ACEI, an ARB, beta blocker, and a diuretic. The following dosages and instructions are available for both heart failures. For ACEI, the treatment should be initiated at low dosages and slowly titrated upward if the patient tolerates them. Captopril should be taken by mouth on an empty stomach (at least 1 hour before meals) usually two to three times a day starting at 6.25 mg initially then increasing to 50 mg three times a day. If a patient is unable to tolerate an ACEI, an ARB would be beneficial because they do not create the same reaction. Losartan (ARB) should be taken by mouth usually once daily with or without food between 25-50 mg then increased to 50-100 mg once a day. (Burcham 521). Adding a beta blocker, such as Metoprolol, can slow progression of heart failure and prolong survival. Metoprolol should be taken by mouth, with or right after a meal, 100 mg and one to three times a day. To reduce your risk of side effects, this medication should start at a low dose and gradually increase. This drug should not be stopped suddenly. A diuretic should only be used if there is an increase in fluid intake. Furosemide is a loop diuretic that prevents the body from absorbing excess salt. This medication should initially be taken every six to eight hours for 20 to 80 mg per dose. (Burcham