Differential Diagnosis
It
is important to exclude mimics of heart failure with preserved ejection
fraction such liver or kidney diseases, hypertrophic or infiltrative cardiomyopathy, amyloidosis, high-output
heart failure, or pericardial or valvular disease.
Patients presenting with reduced exercise tolerance
may have the medical conditions manifesting as dyspnea such as obstructive or
restrictive pulmonary disease, pleural disease, pulmonary embolism,
CAD, myocardial ischemia, arrhythmias, valvular heart disease,
pericardial disease, anemia, neuromuscular disease,
and obesity; or fatigue such as deconditioning, depression, and
sleep apnea.
Patients presenting with fluid retention (eg edema, ascites) should be ruled out for cirrhosis, drug side
effects (steroids, NSAIDs, calcium channel blockers), renal sodium retention,
renal failure, venous insufficiency, thrombosis, pregnancy, malnutrition, and malabsorption.