Understand Chronic Diastolic Heart Failure, also known as Heart Failure with Preserved Ejection Fraction (HFpEF). This resource provides information on diagnosis, clinical documentation, and medical coding for HFpEF, supporting healthcare professionals in accurate and efficient patient care. Learn about symptoms, treatment, and management of diastolic heart failure for improved clinical outcomes.
Also known as
Diastolic heart failure
Heart fails to properly fill with blood during relaxation.
Heart failure
Heart's inability to pump sufficient blood.
Hypertensive heart disease with heart failure
Heart failure caused by high blood pressure.
Left ventricular diastolic dysfunction
Impaired relaxation/filling of heart's left ventricle.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the diastolic heart failure chronic?
Yes
Is there left ventricular systolic dysfunction?
No
Do not code as chronic. See guidelines for acute diastolic heart failure.
When to use each related code
| Description |
|---|
| Heart pumps blood normally but is stiff and doesn't fill properly. |
| Heart pumps too weakly to meet body's needs, reduced ejection fraction. |
| Temporary heart failure due to acute condition like heart attack. |
Coding HFpEF as unspecified heart failure due to documentation lacking clear diastolic dysfunction evidence.
Incorrectly coding hypertension or other comorbidities already inherent in the HFpEF diagnosis, leading to overcoding.
Coding HFpEF without documented preserved ejection fraction (>=50%), risking inaccurate severity and reimbursement.
Q: How can I differentiate between Chronic Diastolic Heart Failure (HFpEF) and other causes of dyspnea in an elderly patient with preserved ejection fraction?
A: Differentiating Chronic Diastolic Heart Failure (HFpEF) from other causes of dyspnea in elderly patients with preserved ejection fraction can be challenging due to overlapping symptoms. Key differentiators include assessing for a history of hypertension, diabetes, and atrial fibrillation, all common comorbidities in HFpEF. Physical exam findings like an S4 heart sound, pulmonary congestion on auscultation, and elevated jugular venous pressure can also point towards HFpEF. Echocardiography plays a crucial role; while EF is preserved, diastolic dysfunction parameters such as E/e' ratio and left atrial enlargement are characteristic of HFpEF. However, other conditions like COPD, pulmonary embolism, and anemia can mimic HFpEF. Consider incorporating BNP/NT-proBNP levels, exercise testing, and cardiac MRI in your diagnostic workup to distinguish HFpEF and refine your treatment strategy. Explore how a multi-modal approach can improve diagnostic accuracy in complex cases.
Q: What are the latest evidence-based guidelines for managing Chronic Diastolic Heart Failure (Heart Failure with Preserved Ejection Fraction) in patients with comorbidities like chronic kidney disease?
A: Managing Chronic Diastolic Heart Failure (Heart Failure with Preserved Ejection Fraction or HFpEF) in patients with comorbidities like chronic kidney disease requires a careful balancing act. Current guidelines from organizations like the American Heart Association and the European Society of Cardiology emphasize meticulous blood pressure control, optimizing diuretic therapy to manage congestion without exacerbating renal function, and addressing underlying comorbidities. Sodium-glucose cotransporter-2 (SGLT2) inhibitors have shown promise in improving both heart failure and renal outcomes in patients with HFpEF and chronic kidney disease. However, close monitoring of renal function is essential. Individualized treatment plans tailored to the patient's specific circumstances, considering both cardiac and renal function, are crucial. Learn more about the latest clinical trial data impacting HFpEF management in complex patient populations.
Patient presents with complaints consistent with chronic diastolic heart failure (HFpEF), also known as heart failure with preserved ejection fraction. Symptoms include exertional dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and fatigue. Physical examination reveals elevated jugular venous pressure, S3 gallop, and pulmonary rales. The patient denies chest pain. Echocardiogram demonstrates normal left ventricular ejection fraction (LVEF) greater than 50%, with evidence of diastolic dysfunction, including impaired left ventricular relaxation and elevated filling pressures. Left atrial enlargement is also noted. Medical history significant for hypertension, hyperlipidemia, and type 2 diabetes mellitus. 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 presentation. Assessment: Chronic diastolic heart failure (HFpEF) with New York Heart Association (NYHA) functional class II. Plan includes optimization of medical therapy for comorbidities including hypertension and diabetes. Diuretic therapy initiated for symptom management. Patient education provided regarding sodium restriction, fluid management, and the importance of medication adherence. Referral to cardiac rehabilitation program for exercise training and further education. Follow-up scheduled in four weeks to assess response to therapy and adjust medications as needed. ICD-10 code I50.33, diastolic heart failure.