Diastolic dysfunction, diagnostic and perioperative management in cardiac surgery

PURPOSE OF REVIEW: The review focuses on recent findings on the role of diastolic dysfunction in the perioperative period and on recent advances in the diagnosis and perioperative management of diastolic function. RECENT FINDINGS: Left ventricular diastolic dysfunction is an underestimated disease with a high risk for acute decompensation in the perioperative period. It has been associated with adverse outcomes in patients undergoing cardiac or noncardiac procedures. Recent advancements in the diagnosis of diastolic function have limited intraoperative applicability. Due to the lack of disease-specific therapies, perioperative management is preventive and symptomatic. SUMMARY: Appropriate perioperative patient care requires that the perioperative physician be alerted to the presence of diastolic dysfunction, be knowledgeable of the diastolic dysfunction grading system and understand the pathophysiologic changes associated with various grades of diastolic function.