Differential diagnosis and clinical management of diastolic heart failure: current best practice Justin Tawil,1 Theresa A Gelzinis2 1Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, 2Department of Anesthesiology, University of Pittsburgh, Pittsburgh, PA, USA Abstract: As the population ages, the prevalence of diastolic dysfunction and heart failure with preserved ejection fraction is rising. The presentation and management of these patients is increasing in frequency and requires an understanding of its pathophysiology, diagnostic methodology, as well as modern therapy for optimal outcome. This review will discuss the mechanisms, clinical stages, diagnostic grading, and therapeutic options for the management of diastolic dysfunction. Keywords: heart failure, echocardiography, diastolic dysfunction, preserved ejection fraction