Chronic diastolic heart failure: what to know

The pumping squeeze may be maintained, but a stiffened heart chamber accepts blood less easily between beats. Pressure can build behind the heart and fluid may collect in the lungs or lower legs. Long-standing high blood pressure, changes in the heart muscle, and irregular rhythms such as atrial fibrillation can contribute. Symptoms may include breathlessness with activity or while lying down, tiredness, a cough, palpitations, or swollen ankles.

A diagnosis is based on your history, examination, blood pressure and heart rhythm, with tests such as an electrocardiogram or echocardiogram when appropriate. The condition is part of the wider heart-failure spectrum; the pattern and cause guide treatment.

Arrange a clinical review if breathlessness, ankle swelling, reduced stamina, or a persistent cough is new or worsening. Take prescribed medicines consistently and do not stop them because you feel better. Keep a record of symptoms, blood-pressure readings if advised, and any noticeable change in swelling or exercise tolerance.

Your clinician may review blood pressure, kidney function, rhythm, other medicines, and conditions that place extra strain on the heart. A chronic disease review can help coordinate these checks and agree on a manageable activity, diet, and follow-up plan.

Seek urgent medical help for severe or rapidly worsening breathlessness, breathlessness at rest, fainting, new confusion, blue or grey lips, or chest pain that does not settle. A fast or very irregular heartbeat with weakness, dizziness, or breathlessness also needs prompt assessment.

Contact your healthcare team soon if swelling is increasing, shoes become tight, you need more pillows to sleep, or your usual activity suddenly becomes harder. These changes can signal fluid build-up even when there is no pain.

Ask what has shown that the problem is mainly related to filling, which other conditions may be contributing, and how you should monitor symptoms at home. Clarify which medicines require monitoring, what activity is suitable, and whom to contact if swelling or breathlessness changes.