Differential Diagnosis for Diastolic Dysfunction
The following differential diagnosis is organized into categories to help guide the thought process:
- Single Most Likely Diagnosis
- Hypertension: This is the most common cause of diastolic dysfunction, as chronic high blood pressure can lead to left ventricular hypertrophy and stiffness, impairing diastolic function.
- Other Likely Diagnoses
- Coronary Artery Disease: CAD can lead to diastolic dysfunction by causing ischemia and scarring of the myocardium, which can stiffen the ventricle and impair relaxation.
- Diabetes Mellitus: Diabetes can cause diastolic dysfunction through various mechanisms, including myocardial fibrosis, vascular stiffness, and autonomic dysfunction.
- Obesity: Obesity is associated with an increased risk of diastolic dysfunction, possibly due to the development of insulin resistance, inflammation, and cardiac steatosis.
- Do Not Miss Diagnoses
- Cardiac Amyloidosis: This condition can cause diastolic dysfunction by depositing abnormal proteins in the myocardium, leading to stiffness and impaired relaxation. Missing this diagnosis can be fatal, as cardiac amyloidosis can progress rapidly.
- Constrictive Pericarditis: This condition can mimic diastolic dysfunction by restricting ventricular filling, and missing it can lead to delayed diagnosis and treatment.
- Cardiac Sarcoidosis: This condition can cause diastolic dysfunction by infiltrating the myocardium with granulomas, leading to stiffness and impaired relaxation. Missing this diagnosis can be fatal, as cardiac sarcoidosis can progress to heart failure and arrhythmias.
- Rare Diagnoses
- Fabry Disease: This is a rare genetic disorder that can cause diastolic dysfunction by accumulating abnormal lipids in the myocardium, leading to stiffness and impaired relaxation.
- Friedreich's Ataxia: This is a rare genetic disorder that can cause diastolic dysfunction by damaging the myocardium and leading to hypertrophy and fibrosis.
- Hemochromatosis: This is a rare genetic disorder that can cause diastolic dysfunction by depositing iron in the myocardium, leading to stiffness and impaired relaxation.