Some heart failure cases going unrecognized in emergency rooms

Dr. Peter Liu, the Scientific Director of the Canadian Institutes of Health Research's Institute of Circulatory and Respiratory Health, looked at nearly three thousand patients admitted to hospitals in Ontario who had been diagnosed by the time they left hospital with heart failure. Yet, fully a third had an ejection fraction rate of more than 50% – in other words, completely normal.

Most cases of heart failure are associated with an enlarged heart. This weakened muscle doesn't pump blood efficiently – known as systolic heart failure. Heart failure with a normal ejection fraction is known as diastolic heart failure. Unlike with systolic heart failure, diastolic heart failure results when the heart doesn't fill up with enough blood in the first place.

Its incidence appears to be growing. It is more common in older patients and in women. It is also associated with high blood pressure and diabetes, both nearing epidemic proportions in our communities.

When Dr. Liu looked into the problem a little more deeply, he found that death rates at 30 days and one year after being admitted to hospital for diastolic heart failure patients was about the same as rates for patients admitted with systolic heart failure. "Research has developed many different ways to treat systolic heart failure, including drugs and surgical procedures," says Dr. Liu. "We don't have the same arsenal of tools when it comes to diastolic heart failure."

We need to find better ways to diagnose diastolic heart failure among patients, says Dr. Liu, and a better way to treat this category of heart failure.