Experiencing fatigue, shortness of breath, and restless sleep, My presented with a systolic blood pressure of 170-180 mmHg and an ejection fraction (EF) of 60%. However, her NT-proBNP level was 3,880 pg/mL, significantly higher than the normal range of below 300 pg/mL for healthy individuals over 75. Dr. Hoang Thi Binh, from the Department of Cardiology at Tam Anh General Hospital in Ho Chi Minh City, diagnosed her with heart failure with preserved ejection fraction (HFpEF), also known as diastolic heart failure.

In HFpEF, the heart's pumping strength (EF) remains normal (above 50%), but the heart's ability to receive blood is impaired. The heart muscle doesn't relax properly, hindering blood flow back into the heart before being pumped to the rest of the body. This is primarily caused by a stiff, less elastic heart muscle that prevents the heart from expanding fully during diastole, reducing the volume of blood it can hold.

Dr. Huynh Thanh Kieu, Head of Cardiology 1 at Tam Anh General Hospital, noted that HFpEF is more challenging to diagnose because the EF remains above 50%. Thorough testing and echocardiography are crucial for accurate diagnosis.

Several factors contribute to HFpEF, including advanced age, obesity, hypertension, diabetes, coronary artery disease, atrial fibrillation, chronic kidney disease, chronic obstructive pulmonary disease (COPD), sleep apnea, and anemia. "My had multiple risk factors and wasn't consistently taking her heart failure medication," Dr. Kieu explained, adding that this type of heart failure carries a similar long-term mortality risk and impact on quality of life as heart failure with reduced ejection fraction (HFrEF), where the EF is below 50%.

My received treatment with diuretics, SGLT2 inhibitors, blood pressure and heart rate control medication, and anticoagulants to prevent blood clots. After three days, her NT-proBNP levels decreased to 1,634 pg/mL, her shortness of breath resolved, and her overall condition improved significantly. She was discharged after six days.

Dr. Binh (left) and Dr. Kieu check on My before her discharge. Photo: Ha Vu

Dr. Binh (left) and Dr. Kieu check on My before her discharge. Photo: Ha Vu

Heart failure is a common condition that occurs when the heart cannot pump enough blood to meet the body's needs or when the heart cannot relax sufficiently, causing increased pressure within the heart chambers. The prevalence of HFpEF is rising in developed countries, potentially due to increased rates of hypertension, metabolic syndrome, kidney dysfunction, and obesity.

Preventing heart failure and cardiovascular problems involves managing blood pressure and maintaining healthy blood sugar levels to minimize damage to the heart and blood vessels. A healthy diet rich in fruits, vegetables, whole grains, and lean protein, along with reduced salt intake, limiting fast food, processed foods, and sugary drinks, is recommended. Maintaining a healthy weight, regular physical activity, reducing alcohol consumption, and quitting smoking are also essential. Regular health checkups are crucial for early detection of any abnormalities.

Thu Ha

*The patient's name has been changed.