Diastolic filling is when the heart muscle relaxes and fills with blood. Abnormal patterns can indicate heart failure or pulmonary stenosis. Diastolic blood pressure measures the pressure when the heart is relaxed. E/A rates can indicate cardiac dysfunction. Treatment depends on the underlying condition.
The period of time in which the heart muscle is relaxed and fills with blood returned to the heart after circulating through the body and lungs is known as diastolic filling. Blood enters the heart through the superior vena cava, pulmonary veins, and inferior vena cava. Abnormal diastolic filling patterns can be a symptom of heart failure or pulmonary stenosis (PS).
Diastolic blood pressure readings measure the arterial pressure within the heart when the muscle is most relaxed during diastolic filling. The lowest measurement taken is the recorded number. In a typical blood pressure measurement, the diastolic pressure is the number at the bottom of the fraction. The other number is systolic pressure, which is the highest measure of atrial pressure, and is recorded as the highest number of a blood pressure fraction.
Diastolic filling rate has two measurements. The early diastolic reading (E) is measured when the blood that remains after the last contraction of the heart muscle flows into the heart. Subsequently, atrial contraction (A) occurs and the filling rate is again measured. An E/A rate can be used to indicate cardiac dysfunction and the need for further testing.
Abnormal filling patterns can be a symptom of heart failure. People with moderate heart failure tend to have lower E and A measurements and longer periods of relaxation of the heart muscle. Severe heart failure is characterized by a short period of relaxation of the heart muscle and elevated E and A measurements.
Many people with pulmonic stenosis have abnormal diastolic filling patterns. Most have a slower rate of filling during phase E and a faster rate during phase A. Muscle hypertrophy is thought to cause the abnormal filling pattern. Treatment for pulmonary valve stenosis is a surgical procedure to widen the pulmonary valve called a balloon valvuloplasty.
The diastolic filling rate can be affected by a tightening of the heart muscle. High blood pressure can cause the muscle on the left side of the heart to tighten up and be unable to relax. Many people have scarred heart muscle after a myocardial infarction or heart attack. Scar tissue is unable to relax enough to allow for proper filling rate.
Some people with diabetes may have stiff heart muscle that impairs diastolic filling. High blood sugar levels can cause glycosylation of the heart muscle. Excess sugar stores in muscle interfere with tissue relaxation, resulting in abnormal fill rates.
Treatment for abnormal diastolic filling rates depends on the underlying condition causing the condition. Medications, including calcium channel blockers and angiotensin converting enzyme inhibitors, can help normalize the filling rate. Some people who also have pulmonary edema may need to take diuretics as part of their treatment schedule.
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