What is the Difference Between Systolic and Diastolic Heart Failure?

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The main difference between systolic and diastolic heart failure lies in the heart's ability to contract and relax during each heartbeat. Both types of heart failure affect the heart's left ventricle and can lead to right-sided heart failure. Here are the key differences between systolic and diastolic heart failure:

  • Systolic Heart Failure: In this type, the heart cannot effectively contract with each heartbeat. The left ventricle loses its ability to contract normally, and the heart can't pump with enough force to push enough blood into circulation. This is also known as heart failure with reduced ejection fraction (HFrEF).
  • Diastolic Heart Failure: In this type, the heart cannot relax between heartbeats. The muscles of the heart become stiff, and the left ventricle can't relax normally. This is also known as heart failure with preserved ejection fraction (HFpEF).

Symptoms of both systolic and diastolic heart failure may feel similar, including shortness of breath during daily activities, difficulty breathing when lying down, weight gain with swelling in the feet, legs, ankles, or stomach, and generally feeling tired or weak. Diagnosis for both types of heart failure uses many of the same tests, such as echocardiography and blood tests.

Treatment for systolic heart failure typically involves medications, while treatment for diastolic heart failure focuses on addressing the underlying causes and managing symptoms. In some cases, surgical procedures may be necessary to treat left-sided heart failure if other treatments are not effective.

Comparative Table: Systolic vs Diastolic Heart Failure

Systolic and diastolic heart failure are two types of heart failure that affect the left ventricle differently. Here is a table summarizing the differences between them:

Feature Systolic Heart Failure Diastolic Heart Failure
Definition Occurs when the left ventricle is unable to contract strongly enough during a heartbeat, leading to an insufficient amount of oxygen-rich blood being pumped out and around the body Occurs when the left ventricle cannot relax properly between heartbeats, leading to elevated filling pressure and increased pressure in the lungs
Also Known As Heart Failure with Reduced Ejection Fraction (HFrEF) Heart Failure with Preserved Ejection Fraction (HFpEF)
Causes Hypertension, myocarditis, cardiomyopathy, coronary heart disease, heart attack, long-term high blood pressure, aortic stenosis, arrhythmia, mitral regurgitation, and others Diastolic dysfunction as a result of heart disease, elevated filling pressure, increased pressure in the lungs, and others
Pathophysiology Contractile dysfunction and left ventricular remodeling Impaired left ventricular filling in diastole, elevated filling pressure, and increased pressure in the lungs
Symptoms Fatigue, shortness of breath, fluid buildup, weight gain, swelling in the legs, ankles, and feet, rapid or irregular heartbeat, persistent cough or wheezing with white or pink blood-tinged mucus, and others Fatigue, shortness of breath, fluid buildup, weight gain, swelling in the legs, ankles, and feet, rapid or irregular heartbeat, persistent cough or wheezing with white or pink blood-tinged mucus, and others
Diagnosis Doctors diagnose both types of heart failure using various tests, including echocardiogram, blood tests, chest X-ray, and others Doctors diagnose both types of heart failure using various tests, including echocardiogram, blood tests, chest X-ray, and others
Treatment Treatment for systolic heart failure focuses on medications, lifestyle changes, and surgical procedures if necessary Treatment for diastolic heart failure focuses on addressing the underlying causes and managing symptoms, as well as lifestyle changes and surgical procedures if necessary