Heart failure with preserved ejection fraction (HFpEF) happens when the heart muscle squeezes like it should, but the heart’s chambers don’t relax properly between beats. Because of this, the heart doesn’t fill up with enough blood, so less blood is pumped out to the body.
What is HFpEF?
HFpEF, which used to be called diastolic heart failure, is different from HFrEF (heart failure with reduced ejection fraction) because in HFrEF, the heart muscle doesn’t squeeze well. HFpEF is more common in older adults, especially women, and is often linked to high blood pressure, diabetes, and being overweight.
Symptoms of HFpEF
The symptoms of HFpEF can look like other types of heart failure, so it’s important to get the right diagnosis. Common symptoms include:
- Breathing difficulty, particularly while exercising or sleeping down
- Feeling tired and weak
- Swelling in the legs, ankles, and feet
- Fast or irregular heartbeat
- Ongoing cough or wheezing
- Needing to urinate more often at night
- Swelling in the abdomen
| Related: ICD-10 Code for Acute Hypoxic Respiratory Failure |
Diagnosis of HFpEF
To diagnose HFpEF, doctors usually look at your medical history, do a physical exam, and run several tests, including:
- Echocardiogram: An ultrasound of the heart to check its structure and function.
- Electrocardiogram (ECG): An examination that logs the electrical activity of the heart.
- Chest X-ray: To look for signs of heart failure or other issues.
- Blood tests: To find markers of heart failure and other related conditions.
ICD-10 Code for HFpEF
The International Classification of Diseases, 10th Revision (ICD-10), is a system that healthcare providers use to classify and code all diagnoses, symptoms, and procedures. I50.3 is the specific ICD-10 code for HFpEF. This code helps standardize the diagnosis and treatment across different healthcare systems, making sure patients get the right care.
| Condition | ICD-10 Code | Description | Clinical Notes |
| Heart Failure with Preserved Ejection Fraction | I50.32 | Heart failure with preserved ejection fraction, acute | Used for acute HFpEF cases where the heart’s ejection fraction is normal but the patient is experiencing an acute episode of heart failure. |
| Heart Failure with Preserved Ejection Fraction | I50.33 | Heart failure with preserved ejection fraction, chronic | Used for chronic HFpEF cases where the condition persists over time and the ejection fraction remains normal. |
| Heart Failure, Unspecified | I50.9 | Heart failure, unspecified | Used when the specific type of heart failure is not documented; may be used in cases where HFpEF is suspected but not confirmed. |
| Hypertensive Heart Disease with Heart Failure | I11.0 | Hypertensive heart disease with heart failure | Used for patients with heart failure associated with hypertension, which may include HFpEF or other types of heart failure. |
ICD-10 Code for Heart Failure with Reduced Ejection Fraction (HFref)
The ICD-10 code for Heart Failure with Reduced Ejection Fraction (HFrEF) is I50.22.
Explanation of the Code:
- I50: The general category for heart failure.
- .2: Indicates chronic systolic (congestive) heart failure.
- 2: Specifies that the heart failure is with reduced ejection fraction.
Detailed Breakdown:
- I50 – Heart Failure: This category includes codes related to different types of heart failure.
- I50.2 – Systolic (congestive) heart failure: Chronic heart failure pertaining to the heart’s systolic function falls under this class.
- I50.22 – Chronic systolic (congestive) heart failure with reduced ejection fraction: This specific code is used to denote chronic heart failure where the heart’s ability to pump blood is reduced due to poor systolic function.
Treatment Options for HFpEF
While there’s no cure for HFpEF, several treatment strategies can help manage symptoms and improve quality of life:
- Medications: Diuretics to reduce fluid buildup, beta-blockers to manage blood pressure and heart rate, and other medications to treat conditions like high blood pressure and diabetes.
- Lifestyle changes: Eating a healthy diet, exercising regularly, and maintaining a healthy weight are crucial.
- Monitoring: Regular check-ups with a healthcare provider to monitor the condition and adjust treatments as needed.
| Treatment Option | Class/Type | Mechanism of Action | Clinical Indications | Key Considerations |
| Diuretics | Loop Diuretics, Thiazides | Reduce fluid overload by increasing urine output | Symptomatic relief of congestion and edema | Monitor electrolytes, avoid over-diuresis, risk of hypokalemia |
| Mineralocorticoid Receptor Antagonists (MRAs) | Aldosterone Antagonists | Block aldosterone, reducing sodium retention and fibrosis | Patients with elevated natriuretic peptides | Monitor for hyperkalemia, renal function, and ensure adequate blood pressure |
| SGLT2 Inhibitors | Sodium-Glucose Cotransporter 2 Inhibitors | Reduce blood glucose and have diuretic-like effects | Diabetic and non-diabetic HFpEF patients | Monitor renal function, blood glucose, potential ketoacidosis in diabetics |
| ACE Inhibitors/ARBs | Angiotensin-Converting Enzyme Inhibitors/Angiotensin II Receptor Blockers | Reduce afterload, decrease systemic vascular resistance | Hypertension management in HFpEF patients | Monitor for hyperkalemia, renal function, and cough with ACE inhibitors |
Managing HFpEF
Living with HFpEF involves ongoing management and lifestyle adjustments. The following advice will help you manage the condition:
- Stay Active: Engage in moderate exercise as recommended by your healthcare provider. Activities like walking, swimming, or cycling can improve heart health.
- Healthy Diet: Consume a diet high in fruits, vegetables, whole grains, lean meats, and balance. Cut back on your salt intake to aid with fluid retention.
- Weight Management: Keep your weight within a healthy range to lessen cardiac strain.
- Quit Smoking: Smoking can worsen heart failure symptoms. Seek support to quit if needed.
- Monitor Symptoms: Keep track of any changes in symptoms and report them to your healthcare provider promptly.
- Medication Adherence: Take medications as prescribed and discuss any side effects with your doctor.
Conclusion
HFpEF is a serious condition that needs careful management and ongoing treatment. It’s important to recognize its symptoms, get an accurate diagnosis, and follow a comprehensive treatment plan to live well with HFpEF. The ICD-10 code I50.3 helps in standardizing the diagnosis and treatment of this condition, making sure patients get the care they need. With proper management, many people with HFpEF can lead active, fulfilling lives.