The Difference Between Systolic and Diastolic Heart Failure

People often believe that “heart failure” means that a person’s heart simply stops beating. However, this chronic condition actually involves any scenario in which the heart’s well-choreographed process for moving blood throughout the body is impaired and functioning is reduced. The American Heart Association says that nearly six million Americans have some degree of heart failure.

Systolic vs. Diastolic Heart Failure

Heart failure can be categorized as systolic or diastolic.

• Systolic heart failure. Also known as “heart failure with reduced ejection fraction (HFrEF),” this form of the condition means that the left ventricle is unable to generate enough force to move blood around the body.
• Diastolic heart failure. Technically referred to as “heart failure with preserved ejection fraction (HFpEF),” diastolic heart failure is characterized by the left ventricle’s inability to relax and allow the inflow of sufficient blood in preparation for the next beat.

A number of conditions can play a role in developing heart failure, including hypertension (high blood pressure), coronary artery disease (hardening of the arteries), diabetes, kidney disease, and an abnormal heartbeat.

Symptoms of Heart Failure

Whether systolic or diastolic in nature, the symptoms of heart failure may include:

• Fatigue and weakness
• Shortness of breath with exertion or when lying down
• Persistent cough or wheezing with white or pink phlegm
• Trouble concentrating or maintaining alertness
• Swelling in the legs, feet, ankles or abdomen
• Rapid weight gain from fluid retention

If you exhibit symptoms of heart failure, one of the procedures your doctor may order is an echocardiogram, an imaging process that produces pictures of your heart. This, along with results from other tests, helps the doctor determine if heart failure is present and, if so, which type. In some cases, a patient may have mixed systolic and diastolic heart failure.

Treating Heart Failure

Different treatments are used for systolic and diastolic heart failure. For systolic heart failure, there is a set of medications that are typically prescribed. Devices like an implantable cardiac defibrillator may also be used.

With diastolic heart failure, treatment tends to involve identifying and treating the condition or conditions (hypertension, diabetes, etc.) behind the heart problem. With either type of heart failure, your doctor will likely recommend lifestyle changes such as reducing your sodium intake, regular low-intensity aerobic exercise, eating a heart-healthy diet, and reducing your alcohol intake.

Heart disease can be successfully treated, but the important first step is talking with your doctor about your symptoms if you are not feeling well.