Signs and Symptoms Pulmonary Crackles/edema, ankle swelling, hepatomegaly, dyspnea on exertion and fatigue. Reduced Exercise Performance (reduced peak Oxygen consumption or 6 minute walking test). Clinical Signs of failure, Chest X ray supporting presence of fluid, typical response to diuretics with or without evidence of low cardiac index. Breathlessness, ankle swelling, fatigue, elevated jugular venous pressure, pulmonary crackles, displaced apex beat LV Systolic Function Normal/Mildly reduced LV systolic function. LVEF ≥50% within 72 hours of HF Normal/only mildly reduced LVEF with LV not being dilated. Diastolic Dysfunction Evidence of abnormal LV relaxation, filling, diastolic distensability or stiffness using invasive measurements or biomarkers. Assessment of diastolic function is not needed for probable diagnosis Relevant structural heart disease (i.e. LV hypertrophy/LA enlargement) and/or diastolic dysfunction

Table 1: Diagnostic criteria for HFpEF.