What is the typical clinical presentation of heart failure with preserved ejection fraction (HFpEF) and its key management?

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In HFpEF the heart’s pumping function (ejection fraction) is preserved, but the ventricle is stiff and fills poorly, leading to higher filling pressures. The usual clinical presentation is dyspnea and edema from congestion. Management focuses on relieving that congestion with diuretics while also controlling blood pressure and aggressively addressing comorbid conditions such as obesity, diabetes, atrial fibrillation, anemia, kidney disease, and sleep apnea. Lifestyle measures like regular exercise, sodium restriction, and weight management support overall care. This multidimensional approach is essential because simply diuresing without addressing these underlying and related issues may relieve symptoms temporarily but doesn’t adequately manage the disease burden or reduce hospitalizations. The other options describe different conditions or suggest an overly narrow treatment (diuresis alone) that misses the broader, comprehensive strategy needed for HFpEF.