hgheith
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This might seem silly, but I am having a hard time trying to put this together, FA has it in a chart really simplified, and Kaplan has a few pages on this.
Is systolic and Diastolic dysfunxn the same as Right and Left heart failure?
Any explanations would be appreciated!
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| me007
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hgheith wrote:
Is systolic and Diastolic dysfunxn the same as Right and Left heart failure?
No-no
Systolic - due to impaired contractility (after recent MI, CMP, myocarditis)
Always decreased EF
Diastolic dysfunction - due to increased stiffness or impaired relaxation (myocardial hypertrophy due to HTN, restrictive CMP, valvular diseases - AS, MS, AR)
Essentially diagnosis of exclusion - is systolic function is N and evidence of CHF.
EF is normal or increased.
When L or R - it is clinical symptoms.
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| CocaCola
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agreed with the post above
Systolic always refers to ejection - so a systolic dysfunction would have impaired ejection (i.e. myocardial disease causing the heart muscle to function abnormally)
Diastolic always refers to filling - so the dysfunstion is always an impairment of filling the heart (i.e. restrictive cardiomyopathy)
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| Vietnamese
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I agree.
However, Echocardiography can diagnose diastolic Heart Failure due to reciprocal E and A wave spectrum. It is pretty complicated and is subspecilaty of Cardiologists.
Clinically, we can not identify diastolic Heart Failure.
Very important note: 1/3 systolic HF, 1/3 diastolic HF and 1/3 (syctolic HF + systolic HF)
Hope this help
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| hgheith
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Thank you guys, but the reason for my confusion is that ejection which is the same as systoli occurs from the Left ventricle, so wouldn't that still correspond to left failure? (and vise versa)?
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| DRamarnath
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hi , go to the basics man , ejection occurs in both the ventricles and so as diastoli
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| deja_vu
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Dramarnath, dont be so rude. someone's having difficulty and he is here to get helped. You also needed the help in some basic concepts. why you forgot that.
hgheith;
Right and Left is about systemic and pulmonary circulation. In left failure, there is pulmonary congestion. In right failure there is systemic congestion. So Dyspnea= Left failure, Edema=Right failure.
Systolic and Diastolic terms define what is the primary hemodynamic problem. If its in the pumping capacity (low EF), it's systolic. If the failure is because the ventrical (Rt or Lt) is not able to expand and fill itself, its diastolic.
See both systolic and diastolic failures result in decrease in output and backpressure buildup. In Left systolic failure ( like dilated cardiomyopathy), there is low ejection as well as pressure in pulmo. veins so fatique+dyspnea. In left diastolic (amyloid heart) there is pressure in pulmo.veins as well as decrease in output (not ejection FRACTION) because that's how we define failure. system is not getting enough blood.
thus systolic and diastolic are decided by what primary hemodynamic abnoramality is responsible for the whole problem. Is it weak contraction [systolic] or weak dilation[diastolic]?
While left and right is all about which system is getting congested. If it's left sided problem(like MS,MR..) then lungs get congested and you get dyspnoea and if its right sided problem(cor pulmonale, TS, TR..), you get edema.
Evantually left leads to right failure and right leads to left failure, but we need to know which one started earlier.
I hope this makes sense. Please correct me.
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| drduck
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i think i was a bit late on this Q,
good job all of u, specially DEJA VU....
no need for any further explanation.......everything done
if i still wanna add something to this i wud say, if u think the physiology way congestive heart failure..... gonna be classified into SYSTOLIC and DIASTOLIC dysfunction.
and if u think by the clinicians way its going to be the symptoms and signs not the function and dysfunction so we gonna classify them as RIGHT and LEFT sided heart failure...
hope this helps
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| silver
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nice expln. deja_vu
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| hgheith
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deja_vu and drduck, thank you guys soo much! I am happy there are still people like all u guys who still want to help others out! I really appreciate it, and now i do get it! That really was a great explanation deja_vu, I do hope you find people like yourself in your path always! I am going to copy this and print it into my notes, kaplan worthy!! 
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| tamerbashir
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thanks
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| tamerbashir
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thanks
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