Cardiac impairment or heart failure?

doi:10.1136/bmj.331.7514.415

BMJ 2005;331:415-416 (20 August), doi:10.1136/bmj.331.7514.415

Editorial

Cardiac impairment or heart failure?

"Heart failure" confuses doctors and patients and needs renaming

The first 150 words of the full text of this article appear below.

"There is no disease that you either have or don't have—exceptperhaps sudden death or rabies. All other diseases you eitherhave a little or a lot of," said Geoffrey Rose.¹ This is trueof "heart failure"—everybody can have a bit if they tryhard enough, by physical exertion or even by emotional shock.²But, apart from transient induced cardiac overload, the termcan be used to mean anything from asymptomatic systolic dysfunctionto imminent death from pulmonary oedema. Because of widely varyingdefinitions, the epidemiology of heart failure can become almostuninterpretable, with estimates of its prevalence in the UnitedKingdom varying from 500 000 to 3 million.³ Moreover, qualitativestudies show that many patients are never told that they haveheart failure because doctors are understandably reluctant touse the term.⁴ When a label confuses doctors and impairs communicationwith patients, it seems sensible to change the . . . [Full text of this article]

Richard Lehman, general practitioner

Hightown Surgery, Hightown Gardens, Banbury, Oxfordshire OX16 9DB
richard.lehman@gp-k84059.nhs.uk

Jenny Doust, senior research fellow in clinical epidemiology

Division of Health Systems, Policy and Practice, University of Queensland, Level 2, Edith Cavell Building, Royal Brisbane Hospital Complex, QLD 4029, Australia

Paul Glasziou, director

Centre for Evidence-Based Practice, Oxford University, Oxford OX3 7LF

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This article has been cited by other articles:

Mitchell, J D. (2005). Cardiac impairment or heart failure?: What about "cardiovascular insufficiency syndrome"?. BMJ 331: 577-577 [Full text]
Michael, A. (2005). Cardiac impairment or heart failure?: "Impairment" is no less alarming or confusing than "failure". BMJ 331: 577-577 [Full text]
Gilbert, C. (2005). Cardiac impairment or heart failure?: Changing the name has knock-on effects. BMJ 331: 577-577 [Full text]
Field, K. H, McPherson, A. (2005). Cardiac impairment or heart failure?: What do patients really think?. BMJ 331: 577-577 [Full text]
Foex, B. A, Carley, S. (2005). Cardiac impairment or heart failure?: Time for total political correctness?. BMJ 331: 577-577 [Full text]

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Cardiac Weakness: James A Dickinson
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Heart Failure�Have a change of Heart?: Chandrakant Madgaonkar
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Cardiac Impairment or Deferred Success?: Bernard A Fo�x, et al.
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Why does the official name need to be changed?: Onisillos Sekkides
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Time to care?: Jonathan Silcock
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It takes more than BNP to diagnose heart failure: Miles D Witham, et al.
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What�s in a name�? A lot, it would seem: Marilyn Kendall, et al.
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Heart Failure - A Paradox: Chandrakant Madgaonkar
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Hearts in a state of deferred success?: R K Mohindra
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Further comments to support time honored heart failure terminology.: Munir E Nassar, M.D.
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Cardiac impairment or heart failure, and natriuretic peptides.: John S Harrop, et al.
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