What are the different types of heart failure?

Doctors use many terms to describe heart failure. A major distinction refers to which part of the heart’s pumping cycle—systolic or diastolic—is primarily affected. As heart failure advances, however, problems will occur in both parts of the cycle.

Systolic heart failure is a problem in the heart’s contracting phase. Systolic heart failure is also called “heart failure with reduced ejection fraction,” or HFrEF. It reflects weakness of the left ventricle, which can’t pump with enough power to send a good supply of oxygen-rich blood out to the body.

Diastolic heart failure is a problem in the heart’s filling phase between heartbeats. Doctors also call this “heart failure with preserved ejection fraction,” or HFpEF. The problem occurs when the heart muscle becomes stiff and thick. The ventricles can’t relax enough to allow the normal amount of blood to enter. This happens most often in elderly women with high blood pressure, diabetes, or both.

The distinction between systolic and diastolic heart failure is important to your doctor because the two types demand different treatment approaches. However, symptoms tend to be similar for both.