Patient presents with symptoms suggestive of Grade 1 Diastolic Dysfunction.  The patient reports exertional dyspnea, which is the primary presenting complaint.  Physical examination revealed normal heart sounds and no murmurs, jugular venous distension, or peripheral edema.  Transthoracic echocardiogram demonstrates normal left ventricular ejection fraction, impaired left ventricular relaxation with an E/A ratio less than 0.8, and an elevated E wave deceleration time.  Left atrial volume index is within normal limits.  These findings are consistent with the diagnosis of Grade 1 Diastolic Dysfunction, also known as impaired relaxation.  Differential diagnoses considered include heart failure with preserved ejection fraction, hypertension induced diastolic dysfunction, and valvular heart disease.  Given the patient's current clinical presentation, the diagnosis of Grade 1 Diastolic Dysfunction is most likely.  Treatment plan includes lifestyle modifications such as regular exercise, sodium restriction, and weight management.  Blood pressure control will be optimized with antihypertensive medication if necessary.  Patient education regarding the importance of medication adherence and follow-up appointments was provided.  The patient will be closely monitored for disease progression and symptom management.  ICD-10 code I51.89, other specified heart disease, and CPT code 93306, echocardiography, complete, are documented for billing and coding purposes. Follow-up echocardiogram scheduled in six months to assess response to therapy and disease progression.