Diastolic dysfunction causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Causes
Any condition or process that leads to stiffening of the left ventricle can lead to diastolic dysfunction.
Some causes of left ventricular stiffening include:
- High blood pressure (i.e. hypertension, where, as a result of left ventricular muscle hypertrophy to deal with the high pressure, the left ventricle has become stiff)
- Aortic stenosis of any cause (here as with hypertension, the ventricular muscle has hypertrophied and thence become stiff, as a result of the increased pressure load placed on it by the stenosis)
- Scarred heart muscle (e.g. occurring after a heart attack) (scars are relatively stiff)
- Diabetes (stiffening occurs presumably as a result of glycosylation of heart muscle)
- Severe systolic dysfunction that has led to ventricular dilation (i.e when the ventricle has been stretched to a certain point, any further attempt to stretch it more, as by blood trying to enter it from the left atrium, meets with increased resistance - it has become stiff
- Reversible stiffening as can occur during periods of cardiac ischemia
One miscellaneous but important cause of diastolic dysfunction is mitral stenosis. In this case, the problem is not that the left ventricle is stiff. Rather, in mitral stenosis, blood cannot readily flow out from the left atrium into the left ventricle since the valve between those two heart chambers is blocked. Especially when the heart rate is elevated (as occurs in exercise and pregnancy), there will be insufficient time for blood to traverse the narrowed passageway (i.e. mitral valve) between the left atrium and left ventricle. As a consequence, the blood will back up into the left atrium and, eventually, the lungs. Pulmonary edema may result.