Pulmonary Hypertension Caused by Diastolic Dysfunction
Every time a healthy heart pumps oxygen-rich blood from the lungs into the rest of the body, it goes through two phases — a contracting or pumping phase (called systolic function) and a relaxing phase (called diastolic function).
When the muscles of the heart become stiff, they can't relax properly, creating a condition known as diastolic dysfunction. This inflexibility prevents the heart's ventricles from filling completely, causing blood to back up in the organs. Diastolic dysfunction is a significant cause of pulmonary hypertension.
Symptoms and Causes of Diastolic Dysfunction
Aging is the most common cause of this stiffening of the heart; in fact, it's estimated that more than 50% of adults of over the age of 70 have diastolic dysfunction. Other causes include high blood pressure, uncontrolled diabetes, kidney dysfunction and — in rare cases — some cancers and genetic disorders.
Diastolic heart dysfunction often creates the same array of symptoms that are found in other types of heart failure and cardiopulmonary diseases, including:
- Shortness of breath with exertion that gets progressively worse
- Excessive fatigue
- Fluid retention in the lower extremities or abdomen (edema)
It's easy to dismiss these symptoms as part of "normal aging." Talk to your doctor whenever you experience these kinds of symptoms. An ultrasound of your heart known as an echocardiogram can confirm a diagnosis of diastolic dysfunction.
The UPMC Treatment Approach
Our physicians in the UPMC Comprehensive Pulmonary Hypertension Program take a cross-disciplinary approach to care, working closely with cardiologists, cardiac surgeons and other experts within the UPMC Heart and Vascular Institute.
By collaborating with physicians in other areas of specialty, we can properly diagnose diastolic dysfunction as a cause of pulmonary hypertension and find the right treatments to help improve your quality of life and sustain your independent lifestyle.
There is no cure for diastolic heart dysfunction, but the symptoms can be managed. We work with patients to pursue a full range of treatment options, including:
- A Healthy Lifestyle - This includes maintaining a healthy weight, eating a balanced diet that's low in salt and getting regular cardiovascular exercise, either on your own or as part of a cardiac rehabilitation program.
- Medications - Water pills can often help to alleviate the edema that is caused by diastolic dysfunction, and other medications can help to treat underlying medical problems like high blood pressure, diabetes or other heart conditions such as atrial fibrillation.
- Left Ventricular Assist Devices (LVAD) - UPMC cardiologists have been on the leading edge of LVAD treatment since the technology was introduced in the 1980s, and have been leaders in improving the technology since then. These implantable devices pump blood into the body just as a healthy heart would, either as a "bridge" while waiting for a heart transplant or as a permanent valve replacement.
- Heart Transplantation - In rare cases, a heart transplant may be considered as a treatment for diastolic dysfunction. Our physicians are leading experts in heart transplantation as part of the UPMC Thomas E. Starzl Transplantation Institute, a nationally regarded center of excellence in transplantation.