Understand Chronic Diastolic Congestive Heart Failure, also known as Heart Failure with Preserved Ejection Fraction (HFpEF) or Diastolic Heart Failure. This resource provides information on diagnosis, clinical documentation, and medical coding for HFpEF, supporting healthcare professionals and accurate medical record keeping. Learn about symptoms, treatment, and the latest clinical guidelines for managing Diastolic Heart Failure. Improve your understanding of this complex cardiac condition with comprehensive and reliable medical information.
Also known as
Diastolic heart failure
Heart failure with preserved ejection fraction.
Heart failure
Covers various types of heart failure, including diastolic.
Hypertensive heart disease
High blood pressure affecting the heart, often leading to diastolic dysfunction.
Heart failure, unspecified
Used when the type of heart failure is not specified but diastolic is suspected.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the diastolic heart failure acute?
Yes
Do NOT code as chronic. Consider I50.3- for acute diastolic heart failure.
No
Is the EF preserved?
When to use each related code
| Description |
|---|
| Heart struggles to fill with blood, ejection fraction normal. |
| Heart's pumping ability weakened, reduced ejection fraction. |
| General heart failure, unspecified diastolic or systolic. |
Coding HFpEF as unspecified HF can lead to lower reimbursement and inaccurate quality reporting. CDI should clarify the diastolic nature.
Associated conditions like hypertension, diabetes, and atrial fibrillation must be documented and coded for accurate risk adjustment.
Underlying causes of diastolic dysfunction should be documented for improved coding specificity and patient care management.
Q: How to differentiate Chronic Diastolic Congestive Heart Failure (HFpEF) from Heart Failure with Reduced Ejection Fraction (HFrEF) in clinical practice?
A: Differentiating Heart Failure with Preserved Ejection Fraction (HFpEF) from Heart Failure with Reduced Ejection Fraction (HFrEF) hinges on assessing left ventricular ejection fraction (LVEF). HFpEF is defined by an LVEF of 50% or greater, often accompanied by symptoms like exertional dyspnea and fatigue despite normal or near-normal systolic function. Conversely, HFrEF presents with a reduced LVEF (below 40%), indicating impaired systolic function. While both share similar symptoms, HFpEF patients often have a distinct profile, including older age, female predominance, and a higher prevalence of comorbidities such as hypertension, obesity, and diabetes. Physical exam findings can overlap, but HFpEF patients may exhibit more pronounced signs of diastolic dysfunction, such as an S4 heart sound. Consider implementing a comprehensive assessment including echocardiography, BNP levels, and exercise testing to confirm the diagnosis and differentiate between HFpEF and HFrEF. Explore how incorporating these diagnostic strategies can improve your patient outcomes.
Q: What are the evidence-based treatment strategies for managing patients with Chronic Diastolic Heart Failure and comorbidities like hypertension and diabetes?
A: Managing Chronic Diastolic Heart Failure, particularly in the presence of common comorbidities like hypertension and diabetes, requires a multifaceted approach. Current guidelines emphasize aggressive control of blood pressure and blood glucose levels. For hypertension, consider implementing medications like ACE inhibitors, ARBs, or beta-blockers as they can improve diastolic function. In diabetic patients, optimizing glycemic control through medications and lifestyle modifications is paramount. Diuretics can be used judiciously to manage fluid overload and alleviate symptoms like dyspnea. Furthermore, addressing other risk factors such as obesity and physical inactivity is essential. Explore how integrating a patient-centered approach that targets both heart failure and comorbid conditions can enhance treatment efficacy. Learn more about the latest clinical trials investigating novel therapies for HFpEF.
Patient presents with complaints consistent with chronic diastolic congestive heart failure (HFpEF), also known as heart failure with preserved ejection fraction. Symptoms include exertional dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and fatigue. Physical exam reveals elevated jugular venous pressure, S3 heart sound, and pulmonary rales. The patient denies chest pain. Echocardiogram demonstrates normal left ventricular ejection fraction (LVEF) greater than or equal to 50%, impaired diastolic filling, and elevated left ventricular filling pressures. Left ventricular hypertrophy is also noted on echocardiography. Diagnosis of chronic diastolic heart failure is made based on the patient's clinical presentation, symptoms, and echocardiographic findings. Differential diagnosis includes other causes of dyspnea such as chronic obstructive pulmonary disease (COPD) and asthma, which were ruled out based on pulmonary function tests and clinical evaluation. Treatment plan includes diuretics for fluid management, beta-blockers to control heart rate, and ACE inhibitors or ARBs to reduce blood pressure and improve cardiac remodeling. Patient education provided regarding lifestyle modifications, including sodium restriction, fluid restriction, and regular exercise. Follow-up scheduled to monitor symptom control, medication effectiveness, and disease progression. ICD-10 code I50.31 (Diastolic heart failure) assigned. Prognosis discussed with the patient.