Table of ContentsView AllTable of ContentsDefinitionsSymptoms and DiagnosisComplicationsRisk Factors and PreventionTreatmentFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Definitions
Symptoms and Diagnosis
Complications
Risk Factors and Prevention
Treatment
Frequently Asked Questions
The heart is the center of the circulatory system, and its main job is to provide nutrient-rich blood and oxygen to all the vital tissues of the body. It is divided into four chambers—two on the right side and two on the left side.
The right atrium receives oxygen-poor blood from two major veins, the inferior and superior vena cava, and sends it to the right ventricle, which pumps it to your lungs via the left and right pulmonary arteries. Here, it picks up oxygen and gets rid of carbon dioxide.
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Oxygen-rich blood from the lungs enters the left atrium and, from there, is sent to the left ventricle. From the left vetricle, the oxygenated blood is pumped to the rest of the body through the aorta, the largest artery.
The heart’s pumping process is called the cardiac cycle. On average one cardiac cycle pumps 5.6 liters (L) of blood throughout the body.
The left ventricle is the chamber that is responsible for pumping blood from the heart to the rest of the body. Dysfunction of the left ventricle leads to two types ofheart failure: systolic and diastolic.
This article details the differences and similarities of systolic and diastolic heart failure.
How Common Is Heart Failure?Heart failure is common in the United States, with over 6 million people living with this condition. Additionally, nearly 1 million new cases are diagnosed each year. Fortunately, medical advances have made it possible to manage heart failure.
How Common Is Heart Failure?
Heart failure is common in the United States, with over 6 million people living with this condition. Additionally, nearly 1 million new cases are diagnosed each year. Fortunately, medical advances have made it possible to manage heart failure.
Systolic and Diastolic Heart Failure Defined
Both sides of the heart are prone to dysfunction, but heart failure on the left side is more common.
The most common culprits of left-sided heart failure are:
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Systolic Heart Failure
Systolic heart failureoccurs when the left ventricle loses its ability to contract. In people with systolic heart failure, blood fills the left ventricle at normal levels, but it cannot be pumped in adequate amounts to support bodily functions. For this reason, systolic heart failure is also called heart failure with reduced ejection fraction (HFrEF). If the body’s tissues are deprived of oxygen, organ failure may ensue.
The most common causes of systolic heart failure are:
Diastolic Heart Failure
Diastolic heart failureoccurs when the left ventricle loses its ability to expand due to stiffness. The heart chamber also is unable to fill with enough blood during the resting periods of the cardiac cycle. As a result, there is less blood available to pump out of the heart.
Because the heart does not lose the ability to contract, diastolic heart failure is also called heart failure with preserved ejection fraction (HFpEF). As you get older, the heart and blood vessels become less elastic, increasing your risk of developing diastolic heart failure.
Other causes of diastolic heart failure include:
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Symptoms
Nearly 3% of Americans experience heart failure, and it is becoming more common in those over 65 years old.Knowing the signs and symptoms of heart failure can help you get an early diagnosis, which can be lifesaving.
If you experience any of the following symptoms of heart failure, seek immediate medical attention:
Class I
Class II
Class III
Class IV
Diagnosis
During the initial evaluation of systolic or diastolic heart failure your healthcare provider or another healthcare professional will take a detailed history and perform the following:
Computed tomography (CT), magnetic resonance imaging (MRI), and nuclear scanning are other imaging tests that may also be used to look at the heart.
Diagnosis of systolic heart failure is based on the following:
Diagnosis of diastolic heart failure is based on the following:
Systolic and diastolic heart failure is a progressive condition that can lead to life-threatening complications if left untreated. The most common complications include:
As previously mentioned, heart failure is more common as you age, but many other factors put you at risk. Fortunately, many of them can be modified. The primary risk factors for diastolic heart failure are:
Several other factors may contribute to developing systolic heart failure, including:
Preventing heart failure is the key to living a happy and heart-healthy life. We now know that heart disease may begin as early as adolescence, even though we may not feel symptoms until much later in life. So, the sooner you adopt healthful behaviors, the better off you will be.
The American Heart Association and the U.S. Preventive Services Task Force recommend the following habits:
Congestive Heart Failure Pathophysiology
In most people, heart failure is a chronic condition that requires lifelong treatment. Most treatments are geared toward slowing down the progression of your heart failure and managing your symptoms.
Whether you have systolic or diastolic heart failure the key is to follow a treatment regimen that includes a combination of diet and lifestyle changes, medicines, and sometimes a device to protect your heart from abnormal rhythms.
The same lifestyle changes necessary for prevention alsohelp manage your symptomsif you have heart failure, including:
Treatment Options for Systolic Heart Failure
Adequate treatment of systolic heart failure may require the use of one or several medications, including:
Treatment Options for Diastolic Heart Failure
The best way to manage diastolic heart failure is to treat its underlying causes, such as hypertension, diabetes, or coronary artery disease.
What is the life expectancy of someone with systolic or diastolic heart failure?
The prognosis of systolic and diastolic heart failure depends on many factors including:
Survival rates in patients with heart failure are 75.9% at one year, 45.5% at five years, and 24.5% at 10 years, compared to 97%, 85%, and 75% in the general population, respectively.
Is it worse to have systolic or diastolic heart failure?
Many studies have concluded that systolic heart failure has a worse 10-year prognosis, but systolic and diastolic heart failure both carry a grim diagnosis, which is why it is important to lead a heart-healthy life.
Is systolic or diastolic heart failure more common?
Compared with systolic heart failure, diastolic heart failure is seen more often in the elderly and women.
More research needs to be done on the prevalence of systolic and diastolic heart failure in different racial and ethnic groups.
Summary
Systolic heart failure occurs when the left side of the heart becomes too weak to squeeze normal amounts of blood out of the heart when it pumps. Diastolic heart failure occurs when the left side of the heart is too stiff to relax and fill normally with blood.
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Heart Association.Causes and risks of heart failure.Ziaeian B, Fonarow GC.Epidemiology and aetiology of heart failure.Nat Rev Cardiol. 2016;13(6):368-378. doi:10.1038/nrcardio.2016.25A.M. McDivit, E.D. Adler, et al.Systemic heart failure. Science Direct.Canadian Journal of Cardiology.Heidenreich PA, Bozkurt B, Aguilar D, et al.2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines [published online ahead of print, 2022 Apr 1].Circulation. 2022;101161CIR0000000000001063. doi:10.1161/CIR.0000000000001063Benjamin EJ, Blaha MJ, Chiuve SE, et al.Heart disease and stroke statistics—2017 update: a report from the American heart association.Circulation. 2017;135(10):e146-e603. doi:10.1161/CIR.0000000000000485MedlinePlus.Heart failure.American Heart Association.Classes and stages of heart failure.American Heart Association.Common tests for heart failure.Colucci, W.Patient education: Heart failure (beyond the basics). Up to Date.Horwich TB, Fonarow GC.Prevention of heart failure.JAMA Cardiol.2017;2(1):116. doi:10.1001/jamacardio.2016.3394Taylor CJ, Ordóñez-Mena JM, Roalfe AK, et al.Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort study. BMJ. 2019;364:l223. doi:10.1136/bmj.l223Olofsson M, Boman K.Impact on mortality of systolic and/or diastolic heart failure in the elderly—10 years of follow-up.Journal of Clinical Gerontology and Geriatrics. 2015;6(1):20-26. doi:10.1016/j.jcgg.2014.10.002Komamura K.Similarities and differences between the pathogenesis and pathophysiology of diastolic and systolic heart failure.Cardiol Res Pract. 2013;2013:824135. doi:10.1155/2013/824135
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Heart Association.Causes and risks of heart failure.Ziaeian B, Fonarow GC.Epidemiology and aetiology of heart failure.Nat Rev Cardiol. 2016;13(6):368-378. doi:10.1038/nrcardio.2016.25A.M. McDivit, E.D. Adler, et al.Systemic heart failure. Science Direct.Canadian Journal of Cardiology.Heidenreich PA, Bozkurt B, Aguilar D, et al.2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines [published online ahead of print, 2022 Apr 1].Circulation. 2022;101161CIR0000000000001063. doi:10.1161/CIR.0000000000001063Benjamin EJ, Blaha MJ, Chiuve SE, et al.Heart disease and stroke statistics—2017 update: a report from the American heart association.Circulation. 2017;135(10):e146-e603. doi:10.1161/CIR.0000000000000485MedlinePlus.Heart failure.American Heart Association.Classes and stages of heart failure.American Heart Association.Common tests for heart failure.Colucci, W.Patient education: Heart failure (beyond the basics). Up to Date.Horwich TB, Fonarow GC.Prevention of heart failure.JAMA Cardiol.2017;2(1):116. doi:10.1001/jamacardio.2016.3394Taylor CJ, Ordóñez-Mena JM, Roalfe AK, et al.Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort study. BMJ. 2019;364:l223. doi:10.1136/bmj.l223Olofsson M, Boman K.Impact on mortality of systolic and/or diastolic heart failure in the elderly—10 years of follow-up.Journal of Clinical Gerontology and Geriatrics. 2015;6(1):20-26. doi:10.1016/j.jcgg.2014.10.002Komamura K.Similarities and differences between the pathogenesis and pathophysiology of diastolic and systolic heart failure.Cardiol Res Pract. 2013;2013:824135. doi:10.1155/2013/824135
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Heart Association.Causes and risks of heart failure.Ziaeian B, Fonarow GC.Epidemiology and aetiology of heart failure.Nat Rev Cardiol. 2016;13(6):368-378. doi:10.1038/nrcardio.2016.25A.M. McDivit, E.D. Adler, et al.Systemic heart failure. Science Direct.Canadian Journal of Cardiology.Heidenreich PA, Bozkurt B, Aguilar D, et al.2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines [published online ahead of print, 2022 Apr 1].Circulation. 2022;101161CIR0000000000001063. doi:10.1161/CIR.0000000000001063Benjamin EJ, Blaha MJ, Chiuve SE, et al.Heart disease and stroke statistics—2017 update: a report from the American heart association.Circulation. 2017;135(10):e146-e603. doi:10.1161/CIR.0000000000000485MedlinePlus.Heart failure.American Heart Association.Classes and stages of heart failure.American Heart Association.Common tests for heart failure.Colucci, W.Patient education: Heart failure (beyond the basics). Up to Date.Horwich TB, Fonarow GC.Prevention of heart failure.JAMA Cardiol.2017;2(1):116. doi:10.1001/jamacardio.2016.3394Taylor CJ, Ordóñez-Mena JM, Roalfe AK, et al.Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort study. BMJ. 2019;364:l223. doi:10.1136/bmj.l223Olofsson M, Boman K.Impact on mortality of systolic and/or diastolic heart failure in the elderly—10 years of follow-up.Journal of Clinical Gerontology and Geriatrics. 2015;6(1):20-26. doi:10.1016/j.jcgg.2014.10.002Komamura K.Similarities and differences between the pathogenesis and pathophysiology of diastolic and systolic heart failure.Cardiol Res Pract. 2013;2013:824135. doi:10.1155/2013/824135
American Heart Association.Causes and risks of heart failure.
Ziaeian B, Fonarow GC.Epidemiology and aetiology of heart failure.Nat Rev Cardiol. 2016;13(6):368-378. doi:10.1038/nrcardio.2016.25
A.M. McDivit, E.D. Adler, et al.Systemic heart failure. Science Direct.Canadian Journal of Cardiology.
Heidenreich PA, Bozkurt B, Aguilar D, et al.2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines [published online ahead of print, 2022 Apr 1].Circulation. 2022;101161CIR0000000000001063. doi:10.1161/CIR.0000000000001063
Benjamin EJ, Blaha MJ, Chiuve SE, et al.Heart disease and stroke statistics—2017 update: a report from the American heart association.Circulation. 2017;135(10):e146-e603. doi:10.1161/CIR.0000000000000485
MedlinePlus.Heart failure.
American Heart Association.Classes and stages of heart failure.
American Heart Association.Common tests for heart failure.
Colucci, W.Patient education: Heart failure (beyond the basics). Up to Date.
Horwich TB, Fonarow GC.Prevention of heart failure.JAMA Cardiol.2017;2(1):116. doi:10.1001/jamacardio.2016.3394
Taylor CJ, Ordóñez-Mena JM, Roalfe AK, et al.Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort study. BMJ. 2019;364:l223. doi:10.1136/bmj.l223
Olofsson M, Boman K.Impact on mortality of systolic and/or diastolic heart failure in the elderly—10 years of follow-up.Journal of Clinical Gerontology and Geriatrics. 2015;6(1):20-26. doi:10.1016/j.jcgg.2014.10.002
Komamura K.Similarities and differences between the pathogenesis and pathophysiology of diastolic and systolic heart failure.Cardiol Res Pract. 2013;2013:824135. doi:10.1155/2013/824135
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