Lack of symptoms awareness delays heart failure diagnosis
Patients with heart failure tend to normalise the symptoms they experience, which results in delayed presentation for primary care, a new study shows.
A total of 16 patients (median age 78.5 years; 11 men) who were recently diagnosed with heart failure were included in the study. Each participant was subjected to semi-structured interviews until there were no more new themes of answers.
Interviews involved asking the participants to narrate their experiences from the first they noticed the manifestation of symptoms up to the point of diagnosis. The framework method was used to analyse the interviews.
Only one interview was conducted over the phone; the rest were conducted personally at the participants’ homes. The average duration of the interviews was 42 minutes.
Shortness of breath was the most common symptom and was often thought of as a normal part of ageing. On the other hand, some participants also reported attributing their breathlessness to other comorbidities.
Other symptoms, like lethargy and swollen ankles, were also normalised as being rooted in other causes like being too busy or being outside their usual environments. Participants thus tended to carry on normally despite these symptoms.
Most of the initial symptoms progressed gradually for months. Participants sought professional help if the symptoms interfered with daily activities or if there were sudden events that needed immediate intervention.
Finally, the degree to which participants understood heart failure was variable. Diagnosis resulted in initial anxiety. Over time, patients learned to accept their diagnoses, researchers said.
The study thus shows that better public understanding of heart failure and its symptoms and manifestations may improve early disease recognition.