Good question @predictable. I think @hopeful33250 @cynaburst @dawn_giacabazi @evelyn247 @matthewbosner may have some thoughts and experiences related to diastolic dysfunction, symptoms and treatments.

Hi @predictable: I have DD it seems to be due to multi-valve regurgitation with the aortic valve having moderate regurgitation with a DX of aortic insufficiency. (My heart valve probs began at age 11 and I’m 68 now, so I feel that I’ve done pretty well, overall.) At this point I’m just taking an Ace Inhibitor but as my last cardio-pulmonary stress test showed a reduced heart functioning from the previous year’s test, my meds may change. I had one cardiologist explain DD this way: if you have DD when your heart is at rest it will remain stiff, not relax entirely. My only symptom seems to be exercise-induced fatigue. It seems that no amount of physical training can help that type of fatigue. If I exercise, I know that I’ll be very fatigued. I still keep exercising, though, because I know that the long-run benefits outweigh the fatigue. I’m looking forward to hearing what you and others have to say about DD as well.

First, I am not a doctor or nurse. However very familiar with hypertension & DD. May I ask what your BP readings have been? Sometimes DD is very mild and the risk does not out weigh the benefit for treatment of the BP. Have they confirmed the DD is the cause of elevated BP? My BP was 300/200’s when I was admitted to St Mary’s Hosp Mayo Clinic. I have DD & hyperaldosteronism. DD is minimal problem. Regular tachycardia which we treat with another hypertension medication along with three others. I would however recommend PGx test for medication management before starting new meds. It will eliminate guessing game on which medications you respond to best

Thanks, @dawn_giacabazi. Under moderately aggressive medication for hypertension, BP in recent months averages 148/98. Diastolic has crept up steadily since a-fib diagnosis two years ago and now repeatedly appears a little above to a little below 100. DD is not yet confirmed (I’ll know more Monday after seeing a cardiologist); it’s a new possibility for me that may explain what caused my a-fib. What is “PGx test?”

PGx Testing:
http://mayoresearch.mayo.edu/center-for-individualized-medicine/drug-gene-testing.asp

Here’s some information on the PGx testing http://mayoresearch.mayo.edu/center-for-individualized-medicine/drug-gene-testing.asp?_ga=1.112643268.1540398701.1440666505

Thanks @cynaburst. Exactly what I needed.

Martin (@predictable)

Thanks @dawn_giacabazi. News to me!

@predictable

Martin, Nice to see you as well as read your messages @predictable. Thanks for adding your avatar picture.

I would like to add the PGx testing is now covered 100% by medicare and most private insurances. It is currently covered by medicaid in 39 states.

Thanks, @colleenyoung. Mayo has always been close to me. If you’re in Rochester, you’ll understand. I grew up in Decorah, 60 miles southeast. My mother died in St. Mary’s Hospital 20 years ago. My brother-in-law got his Pacemaker at Mayo. My brother died at Gunderson in LaCrosse while awaiting test results from the Mayo lab. On the positive side, family and friends always felt more secure, knowing that Mayo was an hour away. I feel the same way today way out here in Virginia. My favored hospital is Virginia Hospital Center in Arlington, a component of Mayo Clinic Care Network. So far, I haven’t had to be admitted there!

Martin

I owe everybody on this thread — especially @hopeful33250, @dawn_giacabazi, and @cynaburst — an update on my Diastolic Dysfunction after visiting with my cardiologist a few days ago. He told me A-fib is the very definition of DD, which is now a condition I probably can’t avoid, and after 2 years of it, I have learned to manage it. Since I have no tangible symptoms (other than a tendency to bleed from wounds, thanks to Coumadin therapy) he saw no reason for surgery and believes no medication would “cure” me. So management is the challenge, and he flatly stated that I need not fear trying a beta blocker in that effort. So my nephrologist prescribed carvedilol to bring my blood pressure down, starting with a minimal dose, possibly raising it over the next six weeks in hope of reaching a maximum positive (balanced) result.

Does this make sense to you? Do you have any suggestions for me based on your experience?