Understanding Acute Diastolic Heart Failure (HFpEF) requires precise clinical documentation and medical coding. This resource provides information on Acute Decompensated Diastolic Heart Failure diagnosis, including symptoms, treatment, and healthcare management. Learn about Heart Failure with Preserved Ejection Fraction and its impact on patient care. Improve your medical coding accuracy and optimize clinical documentation for diastolic heart failure.
Also known as
Diastolic heart failure
Heart failure with preserved ejection fraction.
Heart failure
Covers various types of heart failure.
Hypertensive heart disease with heart failure
Heart failure caused by high blood pressure.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the diastolic heart failure acute?
Yes
Is EF preserved/normal?
No
Is EF preserved/normal?
When to use each related code
| Description |
|---|
| Heart fails to fill properly. Preserved ejection fraction. |
| Heart fails to pump effectively. Reduced ejection fraction. |
| Gradual worsening of diastolic dysfunction. Preserved EF. |
Coding acute diastolic HF without specifying HFpEF can lead to underpayment and data inaccuracy. CDI should query for clarification.
Underlying conditions like hypertension or diabetes impacting diastolic HF must be documented and coded for accurate risk adjustment.
Distinguishing between acute and chronic diastolic HF is crucial. Improper coding can affect severity scores and reimbursement.
Q: How do I differentiate acute diastolic heart failure (HFpEF) from acute systolic heart failure in a patient presenting with acute dyspnea?
A: Differentiating acute diastolic heart failure (HFpEF) from acute systolic heart failure (HFrEF) in a dyspneic patient requires a multi-faceted approach. While both present with similar symptoms, key distinctions lie in ejection fraction (EF) and underlying pathophysiology. In acute HFpEF, the EF is preserved (>=50%) and the primary issue is impaired myocardial relaxation and filling, leading to elevated filling pressures. Conversely, HFrEF involves reduced EF (<40%) and impaired contractility. Physical exam findings like an S3 gallop may be present in HFrEF, while an S4 is often heard in HFpEF. BNP/NT-proBNP levels are typically elevated in both but may be lower in HFpEF. Echocardiography plays a crucial role, confirming EF and assessing diastolic function parameters like E/e' ratio, mitral inflow velocities, and left atrial size. Consider implementing a systematic approach using clinical presentation, biomarkers, and echocardiographic findings for accurate diagnosis and tailored treatment strategies. Explore how S10.AI can assist in risk stratification and management of acute heart failure.
Q: What are the best evidence-based management strategies for acute decompensated diastolic heart failure in the ED setting?
A: Managing acute decompensated diastolic heart failure (HFpEF) in the emergency department requires a rapid and targeted approach focusing on symptom relief and stabilization. Initial management prioritizes oxygenation and ventilatory support if needed. Diuresis is crucial for managing volume overload, the hallmark of acute HFpEF exacerbations. Intravenous loop diuretics are often the first-line choice, with careful monitoring of renal function and electrolyte imbalances. Nitroglycerin can be used cautiously to reduce preload and improve dyspnea, especially in patients with hypertension. However, avoid excessive hypotension, which can worsen symptoms. Non-invasive ventilation (NIV) may be considered for patients with respiratory distress. Managing comorbidities like hypertension and atrial fibrillation is also essential. Learn more about the latest guidelines for acute heart failure management and consider implementing standardized protocols for optimal patient outcomes in the ED.
Patient presents with acute diastolic heart failure (HFpEF), also known as heart failure with preserved ejection fraction and acute decompensated diastolic heart failure. Symptoms include acute onset of dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and pulmonary edema. Physical exam reveals elevated jugular venous pressure, S3 gallop, and bibasilar rales. The patient denies chest pain. Ejection fraction is preserved on echocardiogram, with evidence of diastolic dysfunction including impaired left ventricular relaxation and elevated filling pressures. Differential diagnosis includes acute systolic heart failure, COPD exacerbation, and pneumonia. Diagnosis of acute diastolic heart failure is supported by clinical presentation, physical exam findings, and echocardiographic evidence of diastolic dysfunction. Treatment plan includes diuresis for fluid overload management with intravenous furosemide, oxygen therapy for hypoxemia, and optimization of chronic heart failure medications such as beta-blockers and ACE inhibitors if tolerated. Patient education provided on fluid restriction, sodium restriction, and medication adherence. Follow-up echocardiogram and cardiology consultation scheduled to assess response to therapy and further evaluate diastolic dysfunction. Prognosis depends on underlying comorbidities and response to treatment. ICD-10 code I50.31 for diastolic heart failure is documented.