Diastolic dysfunction

Reduced ventricular compliance or increased resistance to filling in diastole

Causes

Structural abnormalities

  • Ventricular hypertrophy
  • Restrictive CM
  • Pericardial Tamponade

Impaired diastolic relaxation

  • IHD
  • Sepsis

Pattern

“small volumes, high pressures”

ä LVEDP with normal or low LVEDV

Pulmonary congestion and ä PAP

AVOID!

Tachycardia (reduced diastoly à worsening dysfunction

AF à Lost AV synchrony à worsening dysfunction

Avoid hypertension

Management

β-Agonists, Milrinone

AV pacing