Congestive heart failure can manifest itself in either the left or the right side of the heart. Left-sided heart failure is the most common of the two, but when left untreated, this condition can lead to the development of right-sided heart failure.
Left-sided heart failure can be either systolic or diastolic, and each of these problems depicts a certain process and follows a different course of treatment.
1. There are two types of left-sided heart failure
If you’ve ever gotten a blood pressure reading, you might already be familiar with the terms systolic and diastolic. What you may not know is that these very same two terms are also used to describe two different types of left-sided heart failure.
Systolic heart failure also goes by the name of heart failure with reduced ejection fraction. In other words, it means that the heart’s left ventricle is no longer capable of sufficiently strong contractions. As a result, the heart is less and less efficient in pumping blood throughout the rest of your body because it lacks the force to do so.
Diastolic heart failure is also known as a heart failure with a preserved ejection fraction. People with this particular type of heart failure will have a stiff and very thick muscle that doesn’t allow the left ventricle to relax as it normally should. That means that between every two heartbeats (diastolic phase), the heart isn’t able to fill with blood as it does in a healthy person.
2. Systolic and diastolic heart failure share some similar causes
People with systolic heart failure might also suffer from:
- Coronary artery disease. When the arteries that supply the heart muscles with blood are stiff, narrow, or completely blocked by a blood clot, your heart muscle receives a lower amount of blood than it normally should. This problem leads to coronary artery disease, one of the main causes of heart disease.
- High blood pressure. Also called hypertension, increased blood pressure has a huge impact on the heart because it must pump blood despite high resistance in the blood vessels, especially in the aorta.
- Heart valve problems. If your heart valves aren’t healthy, that means they fail to open and close to allow just enough blood in and out of the heart. When this occurs, the heart also struggles to pump enough blood to make up for the missing supply.
- Cardiomyopathy. This is a progressive heart disease which is characterized by stiff, thick, or enlarged hearts, depending on the type. Cardiomyopathy makes it harder for the heart to pump blood efficiently, which can lead to systolic heart failure. Cardiomyopathy is a progressive disease.
Diastolic heart failure can be caused by high blood pressure and coronary artery disease, but it also has other risk factors, such as:
- Advanced age. This type of heart failure usually occurs in elderly patients.
- Extra weight. Obese people or those who are physically inactive could have problems with the heart overworking to pump blood faster.
- Female gender. Elderly women are more likely to develop diastolic heart failure than men.
3. Diastolic heart failure may be difficult to treat
Choosing the best treatment for diastolic heart failure can be challenging. In a few cases, the treatment for systolic heart failure has proven efficient in treating diastolic heart failure as well, but that’s not always the case, especially when considering that these two conditions have a different pathophysiology.
One study suggested that the use of a potassium-sparing diuretic could help certain individuals with this condition, but we need more large randomized controlled trials to draw a conclusion that could be in the best interest of the majority of patients.
According to the American Heart Association and American College of Cardiology, people who have diastolic heart failure should have their blood pressure monitored constantly and might benefit from diuretics that help with lung congestion and leg swelling.
In some cases, bypass surgery or angioplasty represent the best treatment path, but this will only help people whose diastolic heart failure was induced by coronary artery disease. That’s why the preliminary step is having the doctor perform tests to assess your condition.
4. Regardless of the type, heart failure can be kept under control
Despite the misconception that heart failure means imminent death, that isn’t the case. While there is no cure for left or right-sided heart failure, the condition can be kept under control and its progress may be slowed down with the right treatment plan.
Depending on the type of heart failure you have, you will be required to take certain drugs that will help with the underlying cause of your condition. This can be either a single drug or a combination of multiple medications that could help, for instance, with high blood pressure and coronary artery disease.
Aside from medication, several surgical interventions and device implants might help slow down the progress of this condition. Naturally, the type of intervention will depend on the cause of the problem. For instance, people who have faulty heart valves that have led to left-sided heart failure might benefit from a valve replacement intervention.
It is the doctor’s job to carefully assess a heart failure patient’s current condition, perform tests to determine what caused the problem, and attempt to keep them both under control by turning to the right procedures and prescribing the medication that’s required in each particular case. No matter if you have systolic or diastolic heart failure, you will have to make the necessary lifestyle changes to slow the progression, but also follow the doctor’s recommendations and take your medication as prescribed.