How to describe grade 1 diastolic dysfunction to a patient?

Explaining Grade 1 Diastolic Dysfunction to a Patient

Grade 1 diastolic dysfunction is the earliest stage of heart filling problems where your heart muscle has trouble relaxing, but your heart pressures remain normal and you may not experience symptoms yet. 1, 2

What Is Diastolic Dysfunction?

• Diastolic dysfunction refers to problems with how your heart fills with blood between beats (during the "relaxation phase") 3
• Your heart has two main functions:
  • Contracting to pump blood out (systolic function)
  • Relaxing to fill with blood (diastolic function) 3
• In Grade 1 diastolic dysfunction, the relaxation phase is impaired, but your heart's overall pumping ability remains normal 1, 2

What Happens in Grade 1 Diastolic Dysfunction?

• Your heart muscle becomes stiffer and takes longer to relax after each contraction 3, 4
• This causes changes in how blood flows into your heart:
  • Decreased early filling (when your heart should naturally fill)
  • Increased late filling (when your heart's upper chambers contract) 3, 2
• Despite these changes, the pressures inside your heart remain normal at this early stage 1, 5
• Your heart's pumping function (ejection fraction) stays normal at >50% 4, 6

How Is It Diagnosed?

• Doctors use an ultrasound of your heart (echocardiogram) to diagnose this condition 3
• They look for specific patterns in how blood flows into your heart 3, 1
• For Grade 1, they typically see:
  • Changes in the ratio of early to late filling (E/A ratio ≤0.8)
  • Normal filling pressures (normal E/e' ratio, typically <8)
  • Normal size of your heart's upper chambers 1, 2

What Causes It?

• High blood pressure is the most common cause 2, 7
• Other common causes include:
  • Aging (very common in older adults)
  • Coronary artery disease
  • Diabetes
  • Obesity
  • Heart valve problems 3, 4

What Symptoms Might I Experience?

• At Grade 1, many people have no symptoms at all 6, 7
• Some may notice:
  • Mild shortness of breath with physical activity
  • Decreased exercise tolerance
  • Occasional fatigue 3, 4
• Symptoms typically develop or worsen during physical exertion when your heart needs to fill more quickly 2, 8

How Is It Treated?

• Treatment focuses on addressing the underlying causes 1, 2:
  • Controlling high blood pressure
  • Managing diabetes
  • Weight loss if overweight
  • Treating coronary artery disease if present
• Medications may include:
  • Blood pressure medications (ACE inhibitors, ARBs)
  • Beta-blockers to control heart rate
  • Other medications based on your specific needs 1, 2, 8

What Is the Outlook?

• Grade 1 is the mildest form of diastolic dysfunction 1, 6
• With proper treatment of underlying conditions, it may not progress further 2, 4
• Regular follow-up with your doctor is important to monitor for any changes 1, 2
• The prognosis is generally good compared to more advanced stages 4, 7

What Can I Do?

• Take all medications as prescribed 2, 8
• Follow a heart-healthy diet low in sodium 2
• Engage in regular moderate exercise as recommended by your doctor 2
• Maintain a healthy weight 2, 8
• Keep all follow-up appointments for monitoring 1, 2