Insuffisance cardiaque aiguë diastolique

Cardiac diastolic dysfunction refers to the inability of the left ventricle to relax, to distend and to fill. It can be considered as the main cause of heart failure in more than half of the patients with chronic heart failure. Even though symptoms of acute heart failure are similar when it is related mainly to diastolic and systolic dysfunction, the underlying pathophysiological mechanisms are very different. The diagnosis of acute heart failure requires the association of signs of heart failure, of a normal or subnormal left ventricular function and of a diastolic dysfunction. It is made by echocardiography. A recent consensus conference has updated the echocardiographic criteria for diagnosing diastolic heart failure. The treatment of acute heart failure from diastolic origin is based upon the reduction of central volemia, the reduction of left ventricular afterload and the correction of precipitating factors like hypertension, atrial fibrillation and myocardial ischemia.