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AUDIO: Dr. Fogoros Talks About Heart Disease & Diastolic Heart Failure

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What is diastolic heart failure?

Dr. Richard Fogoros: Diastolic heart failure is a form of cardiac disease that has been increasingly recognized over the last ten years. It can occur in both men and women but it’s far more common in women than in men, about 75 percent of people who get this problem are women. Now typical and typical heart failure, the heart muscle itself becomes very weak and flaccid and that’s what causes the heart failure. Heart failure basically just means the heart is not able to do all of the work it’s supposed to do to supply blood to the body’s organs.

With diastolic heart failure, on the other hand, the heart muscle itself remains strong and the problem is that the heart muscle is stiff, that is it contracts just fine, it pumps just fine but during the filling phase of the heart cycle, that is where the ventricles, the big pumping chambers are filled with blood. It becomes more difficult to fill them because they’re relatively stiff and that eventually leads to problems with high pressures within the heart, the high pressure is back up into the lungs causing the ones to fill the fluid and that means the heart failure.

The classic way that these patients come in to the hospital is that they come in with an acute episode of heart failure, that is they are extremely short of breath, they feel like they’re going to die, their lungs are filled with fluid, they come into the emergency room, they get the diarrhetics, that is the water pills and other therapies and the water is removed from their lungs and they feel fine, and then you do some sort of test to see what’s causing their heart failure and to everybody’s surprise, the heart muscle looks perfect, it looks really good.

Until a few years ago, no one really knew what that meant but with modern echocardiographic technology, that echocardiogram being a way of imaging the heart using sound waves, we can now study the diastolic component of the heart, that is the filling phase of the cardiac cycle and we can see that the heart muscle is stiff.

Now it turns out these patients don’t have a very good prognosis. It’s probably a little better than people that have a typical weak heart muscle form of heart failure but it’s still a fairly dangerous problem and the treatment is not particularly clear.

Well, as it turns out, most of the people to have this diastolic heart failure are older. So it just looks like the heart becomes stiffer as you get older and that’s probably just one of the things that happens with aging but it also turns out that these people have a long history of hypertension, high blood pressure and it is probably true that high blood pressure contributes remarkably to this diastolic heart failure and one of the main treatments of diastolic heart failure is to reduce the blood pressure but what this also means is that treating high blood pressure when you’re younger is almost certainly going to be the major way of preventing this problem and the problem does appear to be a lot more prevalent than previously been recognized and it is far more common in women than in men.

Richard N. Fogoros, M.D. (Dr.Rich) is a former professor of medicine, and a longtime practitioner, researcher and author in the fields of cardiology and cardiac electrophysiology. He currently makes as a consultant in research and development with biomedical companies, and as a writer.

Experience: Dr. Rich practiced and taught clinical cardiology for 20 years, directing cardiac electrophysiology at the University of Pittsburgh, and then at Allegheny General Hospital in Pittsburgh. He was listed in Best Doctors in America from its inception until he retired from practice. He has authored numerous scientific articles, book chapters, and books.

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