Clinical Diagnosis and Management of Left Ventricular Diastolic Dysfunction
Diastolic dysfunction is a relatively common problem that may be mild and asymptomatic or it may present with severe disabling symptoms. It is most frequently due to coronary artery disease and/or left ventricular (LV) hypertrophy, and it is especially common in the older populations. Patients with diastolic dysfunction and normal-systolic function are best treated with calcium-channel blocking agents or beta-blocking agents (drugs that are generally avoided in patients with significant systolic dysfunction). These drugs are used in the same dosage as used in patients with angina or hypertension. Most treatment is empirical or based on symptomatic relief and, therefore, periods of cautious trial and error are the rule. When diastolic dysfunction is associated with systolic dysfunction, it may be necessary to treat both conditions, but in general, positive inotropic agents and arterial vasodilators are not useful in patients with diastolic dysfunction.
KeywordsDiastolic Dysfunction Left Ventricular Filling Mitral Valve Disease Peak Filling Rate Ventricular Diastolic Dysfunction
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