Approach to Echocardiography in Heart Failure with Preserved Ejection Fraction

The echocardiogram is universally performed in the evaluation of suspected HFpEF and provides the initial screen for alternate causes of heart failure. No single echo feature is pathognomonic for HFpEF diagnosis and therefore echocardiographic abnormalities must be viewed in a probabilistic sense for the potential diagnosis of HFpEF. Dyspneic patients with HFpEF may not have obvious abnormalities at rest, and exercise testing is often required to confirm or refute the diagnosis. Once HFpEF has been confirmed, echocardiography is essential to provide structural and functional information to pathophysiologically phenotype patients.