What Is Diastolic Heart Failure?

Written by Mary Jo DiLonardo, Stephanie Booth
Medically Reviewed by Shruthi N, MD on May 18, 2025
6 min read

If you have diastolic heart failure, the left ventricle of your heart has become stiff and bulky. So, your heart can’t fill up with as much blood as it needs. Less blood in your ventricle means that less blood gets sent out to the rest of your body.

“Receiving a diagnosis of diastolic heart failure can be concerning, even overwhelming — especially for those who have spent a long time searching for answers,” says Christopher Berg, MD, board-certified cardiologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, CA. “The encouraging news is that once the condition is identified, there are meaningful steps that can be taken to manage it.”

Diastolic vs. systolic heart failure

Diastolic heart failure is different from systolic heart failure, in which your left ventricle can’t pump hard enough to push out a healthy amount of blood.

With diastolic heart failure, your left ventricle has become rigid. If you have systolic heart failure, it has become limp.

As you get older, your heart and blood vessels naturally stiffen. So, aging is the most common cause of this heart issue. Other reasons include:

High blood pressure. If you have it, your heart has to work harder to pump more blood through your body. Because of all that extra work, your heart muscle may get thicker or larger. Learn more about the symptoms of high blood pressure.

Diabetes. This condition can raise your risk of heart failure and cause it to happen at a younger age. Read more on how diabetes affects your heart.

Coronary artery disease. If plaque, like cholesterol, builds up inside your blood vessels, it can block blood flow to your heart muscle. Find out more about the different types of cardiovascular diseases.

Obesity/inactivity. With either, your heart has to work much harder to pump blood. Get information on the health risks linked to obesity.

Chronic kidney disease (CKD). If your kidneys can no longer flush out excess fluids in your body, your risk of heart failure goes up.

Sleep apnea. If you have this disorder, you don’t breathe as much as you should while you sleep. That can lead to irregular heartbeats and lower oxygen in your blood, which harms your heart over time.

Atrial fibrillation (AFib). When your heart’s upper chambers don’t beat in a rhythmic pattern, the lower chambers (ventricles) work harder, which can weaken them over time.

Common diastolic heart failure symptoms can include:

To figure out if you have heart failure, your doctor will do a physical exam and ask about your health history. They’ll want to know if you have symptoms such as:

  • Shortness of breath, especially when you work out or lie down
  • Swelling in your ankles, legs, or belly
  • Fatigue (feeling tired even after resting)
  • Bulging neck veins
  • Feeling dizzy
  • Peeing more than usual
  • Coughing
  • Wheezing

They’ll also run tests such as:

  • An echocardiogram. This is an ultrasound that looks at your heart and can tell how well it’s pumping.
  • Blood tests.
  • Electrocardiogram (EKG). A quick in-office procedure, an EKG checks your heart’s electrical activity.
  • Chest X-ray. These images let your doctor see the size and shape of your heart.
  • Exercise test (stress test). You may be asked to walk on a treadmill so your doctor can see how your heart reacts when it beats faster.
  • Heart catheterization. If your doctor wants to check different pressures in your heart, they may do this test.

“Although there is not an easy cure for this condition, proper management can greatly improve symptoms and overall quality of life,” says Cheng-Han Chen, MD, medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA. 

A diastolic heart failure treatment plan often includes both lifestyle changes and medications.

Lifestyle changes

Your doctor will probably suggest that you:

  • Cut back on sodium. Aim for less than 2,000 mg of sodium each day (less than one teaspoon of table salt). Use fresh herbs or salt-free seasonings instead, and opt for low-sodium or sodium-free packaged foods.

  • Eat more fresh foods. Look for unprocessed foods such as fruits, vegetables, whole grains like brown rice and oats, unsalted nuts and seeds, fresh meats, and dairy products that are low in sodium.

  • Get regular exercise. Physical activity helps your heart work better, and losing extra pounds can help ease strain on your heart. Ask your doctor which activities are safe for you to do.

  • Cut out tobacco. Nicotine raises your heart rate and blood pressure. If you aren’t sure how to quit, ask your doctor for the first step you can take.

  • Cut back on alcohol. Generally, men should have no more than two drinks per day, and women should have no more than one. Your doctor may want you to follow other guidelines.

  • Get quality sleep. When you do, your blood pressure naturally goes down, and your heart doesn’t have to work as hard.

  • Find new ways to manage your stress. Excess worry and anxiety can strain your heart. Many options can help, such as yoga, meditation, or joining a support group. 

  • Manage other health issues. If you have another chronic condition, such as sleep apnea, diabetes, or high blood pressure, follow your doctor’s treatment plan.

Medications

You may need to take one or more drugs as part of your treatment. Common heart failure medications for diastolic heart failure include:

  • Diuretics, which help ease swelling
  • Mineralocorticoid receptor antagonists, a type of diuretic that gets rid of extra salt and fluid but helps the body keep potassium
  • High blood pressure medication
  • SGLT2 inhibitors, usually used to treat diabetes, these drugs can help improve your heart function

“Proper diagnosis and appropriate treatment can help you control your symptoms, avoid hospitalizations, and live for many years,” Chen says.

The same healthy habits mentioned above are also the easiest ways to protect your heart.

  • Follow a “heart-healthy” eating plan.
  • Find a physical activity you enjoy so you get in the habit of doing it often.
  • Get better at dealing with stress.
  • Cut back on alcohol, and try to quit smoking.
  • Try to sleep seven to eight hours each night.
  • See your doctor regularly and follow their advice.

If you have diastolic heart failure, the left ventricle of your heart has gotten too stiff and doesn’t fill with enough blood to meet your body’s needs. There’s no cure, but different medications can help control your symptoms. Making changes to your daily life, such as being active, eating more whole foods, getting enough sleep, and cutting back on sodium, alcohol, and tobacco, will also be key.

How long can someone live with diastolic heart failure?

Many people diagnosed with this condition live a full life. But it is important to follow your doctor’s advice so you can manage your symptoms.

How serious is diastolic dysfunction?

Diastolic dysfunction is an issue with the first part of your heartbeat (the diastole). If left untreated, it can worsen and turn into diastolic heart failure.

Is diastolic heart failure the same as congestive heart failure?

These are two different conditions. Diastolic heart failure affects the left side of your heart. Your left ventricle can’t relax like it should, which means it can’t fill properly with blood. As a result, it doesn’t pump out enough blood to the rest of your body. Congestive heart failure means that blood has backed up in your heart. This can affect organs such as your lungs and kidneys, and it’s a medical emergency.

Can diastolic heart failure be cured?

There’s no cure for this heart issue, but prescription medications and healthy lifestyle changes can help you control your symptoms and allow you to have an active life.