Differential Diagnosis
It is important to exclude
mimics of heart failure with preserved
ejection fraction such liver or kidney diseases, hypertrophic or
infiltrative cardiomyopathy, 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, myocardial
ischemia, arrhythmias, valvular heart disease, pericardial disease, anemia, and
neuromuscular disease; 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.