Chronic combined systolic and diastolic heart failure

Systolic dysfunction means the heart does not squeeze as effectively as it should. Diastolic dysfunction means it does not relax and fill normally. When both are present, pressure can build behind the heart and fluid may collect, causing breathlessness, cough, tiredness or swollen ankles. Palpitations may point to an abnormal rhythm such as atrial fibrillation, but symptoms can have several causes.

Assessment may include an examination, blood tests, an electrocardiogram and an echocardiogram. Your clinician may also review blood pressure, kidney function, weight changes, medicines and other conditions that affect the heart.

Take heart medicines exactly as prescribed and do not stop them suddenly. Attend your Chronic Disease Review appointments so symptoms, blood pressure, kidney tests and medicines can be checked. Record changes in breathing, swelling, energy, sleep position and weight if your care team has asked you to monitor them.

Ask how much activity is suitable, whether salt or fluid changes apply to you, and what to do if a dose is missed. Keep a current medicine list and tell clinicians about dizziness, worsening fatigue or new palpitations.

Call emergency services for severe breathlessness at rest, chest pressure, fainting, blue or grey lips, sudden confusion, or coughing pink frothy fluid. Seek prompt medical advice for rapidly increasing swelling, a clear worsening in exercise tolerance, or a fast or irregular heartbeat with weakness or breathlessness.

Ask which heart function measurements apply to you, what improvement should look like, and how your medicines protect the heart. Discuss blood-pressure targets, rhythm checks, activity guidance, fluid advice and the exact symptoms that require same-day help.