Diastolic dysfunction of the left ventricle. A review of the physiology, causes, diagnosis, treatment and implications

Diastolic dysfunction of the left ventricle frequently occurs in people with left ventricular hypertrophy and coronary artery disease. It is a common cause of congestive heart failure, especially in the elderly. The mechanism of diastolic dysfunction, its causes, diagnosis and treatment, are reviewed. These are important factors to a Medical Director who must assess the results of non-invasive studies. Alerted by the possibility of diastolic dysfunction, the Medical Director can be more sensitive to other signs and symptoms that may represent early signs of congestive heart failure or ischemia.     

Doppler echocardiographic changes found in diastolic dysfunction

Diastolic dysfunction may be associated with increased morbidity and mortality. In this article, an overview of the pathophysiology of diastolic dysfunction is discussed and the findings of Doppler echocardiography used to aid in its diagnosis are reviewed.     

Creativity and dysfunction in strategic processes: The case of scenario planning

This paper attempts to open up a new line of enquiry into the dysfunctions of creativity within strategic processes. Generally, the impact and results of introducing creativity (and innovation) into organisational life are perceived to be wholesome and beneficial. But recent research in the area of organisational psychology has documented a ‘dark’ side to its introduction, e.g., low employee morale, stress, theft, sabotage, destructive conflict. Learning from this work and shifting the domain to strategic management, this paper focuses on scenario planning—a strategy process widely regarded by participants and facilitators as creative and innovative in structure, content and output. First, the creative credentials of the process are established with reference to the literature and definitions from the creative and cultural industries. Second, the process is deconstructed into activities and each is examined for the extent of its embedded creativity. Third, informed by case evidence, four dysfunctions of the scenario planning process are conjectured: creativity layered on fantasy; heightened expectations and confusion; pride and passion; and creativity leading to excess. The paper concludes by suggesting four options for handling these potential dysfunctional effects and, in the light of the dialogue presented, re-interprets the definition of scenario planning presented earlier in the text.