Understanding Acute on Chronic Diastolic Heart Failure, also known as Acute on Chronic Heart Failure with Preserved Ejection Fraction or Acute on Chronic Diastolic Congestive Heart Failure, is crucial for accurate clinical documentation and medical coding. This resource provides information on diagnosis, treatment, and management of this condition, focusing on healthcare best practices and optimized for medical professionals and coding specialists seeking clarity on this complex heart failure presentation. Learn about the nuances of diastolic heart failure, preserved ejection fraction, and the implications of acute decompensation in chronic cases for improved patient care and accurate medical record keeping.
Also known as
Diastolic heart failure
Heart failure with preserved ejection fraction.
Hypertensive heart disease with heart failure
High blood pressure leading to heart failure.
Heart failure
General category for various types of heart failure.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the EF preserved/normal?
Yes
Acute on chronic?
No
Acute on chronic?
When to use each related code
| Description |
|---|
| Sudden worsening of chronic diastolic heart failure. |
| Chronic heart failure with impaired relaxation/filling of the ventricles. |
| Acute heart failure with preserved ejection fraction. |
Coding acute on chronic diastolic HF requires precise documentation of both acute and chronic components, along with diastolic dysfunction evidence (e.g., preserved EF). Ambiguous documentation may lead to less specific codes.
Diastolic heart failure is often associated with other conditions (e.g., hypertension, atrial fibrillation). Accurate coding and capture of all relevant comorbidities are crucial for proper risk adjustment and reimbursement.
Accurate reporting of ejection fraction (EF) is critical for distinguishing diastolic HF (preserved EF) from systolic HF (reduced EF). Lack of documented EF or inconsistent findings can lead to coding errors.
Q: How to differentiate acute on chronic diastolic heart failure from acute decompensated heart failure with reduced ejection fraction in a clinical setting?
A: Differentiating acute on chronic diastolic heart failure (HFpEF) from acute decompensated heart failure with reduced ejection fraction (HFrEF) requires careful evaluation. While both present with similar symptoms like dyspnea and edema, key distinctions lie in echocardiographic findings. HFpEF demonstrates preserved ejection fraction (EF > 50%) with evidence of diastolic dysfunction like impaired relaxation or elevated filling pressures. In contrast, HFrEF exhibits reduced EF (< 40%) with systolic dysfunction. Furthermore, patients with acute on chronic diastolic heart failure often have a history of hypertension and other comorbidities like diabetes and atrial fibrillation. Consider implementing a comprehensive assessment including a thorough history, physical exam, echocardiography, and natriuretic peptide levels to accurately distinguish between these two conditions. Explore how incorporating these elements can enhance your diagnostic accuracy.
Q: What are the best evidence-based management strategies for acute on chronic diastolic heart failure exacerbations in patients with multiple comorbidities?
A: Managing acute on chronic diastolic heart failure exacerbations in patients with multiple comorbidities requires a tailored approach. Given the frequent presence of conditions like hypertension, diabetes, and chronic kidney disease, treatment focuses on optimizing these underlying conditions alongside heart failure management. Evidence-based strategies include aggressive diuresis to relieve congestion, careful blood pressure control to avoid hypotension, and meticulous monitoring of renal function. Additionally, optimizing heart rate control, particularly in patients with atrial fibrillation, is crucial. Learn more about the individualized approaches for managing these complex patients considering their comorbidity profile and exploring the latest guidelines for optimal management.
Patient presents with acute on chronic diastolic heart failure (also known as acute on chronic heart failure with preserved ejection fraction or acute on chronic diastolic congestive heart failure). The patient's symptoms include shortness of breath (dyspnea), particularly with exertion and when lying flat (orthopnea), paroxysmal nocturnal dyspnea, fatigue, and peripheral edema. Physical exam reveals elevated jugular venous pressure, pulmonary rales or crackles, and an S3 heart sound. Echocardiogram demonstrates preserved left ventricular ejection fraction (LVEF) greater than or equal to 50%, with evidence of diastolic dysfunction such as impaired left ventricular relaxation or increased filling pressures. The patient's medical history includes long-standing hypertension and type 2 diabetes mellitus, both of which are contributing factors to their chronic diastolic heart failure. Current medications include lisinopril, metformin, and rosuvastatin. Assessment includes review of BNP levels and assessment of renal function. Plan includes optimization of diuretic therapy to manage fluid overload, adjustment of blood pressure medications to achieve optimal control, and patient education regarding fluid restriction and sodium intake. Differential diagnoses considered include acute decompensated heart failure, pulmonary embolism, and pneumonia. Follow-up echocardiogram and cardiology consultation are scheduled.