Reasons for decreased ventricular end diastolic filling

Reduced ventricular end diastolic filling may be caused by insufficient blood volume, decreased myocardial compliance, pericardial disease, arrhythmia, heart valve disease, and other reasons.

1. Insufficient blood volume:

Severe dehydration, heavy bleeding, or long-term insufficient fluid intake can lead to a decrease in circulating blood volume, directly affecting ventricular diastolic blood reflux. Patients may experience dehydration symptoms such as reduced skin elasticity and decreased urine output, and require fluid replacement therapy to restore effective circulating blood volume. If necessary, blood transfusion may be needed to correct the bleeding state.

2. Decreased myocardial compliance:

hypertensive heart disease, myocardial hypertrophy, or myocardial fibrosis can reduce ventricular wall elasticity, limiting diastolic expansion. This type of change is common in long-term uncontrolled hypertensive patients, which may be accompanied by chest tightness and decreased activity tolerance. Treatment requires controlling blood pressure and improving myocardial remodeling. Commonly used drugs include angiotensin-converting enzyme inhibitors and beta blockers.

3. Pericardial diseases:

Pericardial effusion or constrictive pericarditis can mechanically restrict ventricular dilation. The patient may present with signs such as strange pulse and jugular vein engorgement, which can be clearly diagnosed by echocardiography. Pericardiocentesis and drainage or pericardiectomy are the main treatment methods. At the same time, it is necessary to treat the causes of tuberculosis, virus infection and so on.

4. Arrhythmia:

Atrial fibrillation or frequent premature ventricular contractions can disrupt atrial ventricular coordination and reduce diastolic filling time. Patients with rapid arrhythmia often experience palpitations and short pulse, which can be restored to sinus rhythm through antiarrhythmic drugs such as amiodarone or electric cardioversion. In severe cases, radiofrequency ablation treatment is required.

5. Cardiac valve disease:

Mitral valve stenosis or aortic valve regurgitation can obstruct the normal direction of blood flow. Auscultation can detect characteristic murmurs, and echocardiography can evaluate the degree of valve stenosis. Mild lesions can be relieved with diuretics, while moderate to severe stenosis may require consideration of valve repair or replacement surgery.

It is recommended to regularly monitor blood pressure and heart rate changes, maintain moderate aerobic exercise such as brisk walking and swimming to enhance cardiovascular function, pay attention to a low salt and high potassium diet, and limit daily fluid intake to 1500-2000 milliliters. When experiencing paroxysmal nocturnal dyspnea or worsening lower limb edema, timely medical attention should be sought, and cardiac ultrasound and BNP testing should be performed to evaluate the cardiac function status. Elderly patients should pay special attention to avoiding electrolyte imbalance caused by excessive diuresis, and those with atrial fibrillation should follow medical advice for anticoagulant therapy.