Getting the diagnosis of heart failure

Receiving a diagnosis of heart failure will always be difficult. Choosing the best time to give the diagnosis is also hard because doctors need to know results of tests and have to take account of each person’s needs. Some people want detailed information about heart failure straightaway, others need reassurance that something can be done to help them. Those we talked to expressed a range of different attitudes to getting a diagnosis and some were still unsure what heart failure meant (see ‘What is heart failure?’).

Some people had been given the diagnosis by a GP and liked talking to someone they knew about their problems; one man described how he was seen by two GPs from the same practice, one of whom has a special interest in heart failure. Several appreciated straight talking, one man said that he had received a very clear picture of his heart failure from a hospital doctor and that he imagined his heart as a ‘withered hand’. but balancing the diagnosis with reassurance was imprtant for others: being told something could be done reduced the shock of the diagnosis for one woman. Several people said they found it difficult to visualise what was happening inside their own body despite having been shown diagrams, ECG print outs and angiograms by doctors.

Received his diagnosis of heart failure from a GP in his practice.

Age at interview 64

Gender Male

Age at diagnosis 63

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He understood his diagnosis and visualises his heart like a withered hand.

Age at interview 62

Gender Male

Age at diagnosis 56

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Was reassured that there was something that could be done for her at diagnosis.

Age at interview 69

Gender Female

Age at diagnosis 67

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He found his diagnosis very difficult to grasp.

Age at interview 49

Gender Male

Age at diagnosis 44

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We spoke to some people who were given a diagnosis in hospital while recovering from emergency treatment; some felt they had been unable to respond because they were shocked and couldn’t think of any questions, and several felt they had been too ill to absorb information about heart failure. Some had other medical problems to cope with, for example one woman whose bypass surgery had caused some complications said she had never been given a diagnosis of heart failure. Several older people were unclear about what the diagnosis was or how it differed from other heart problems. It was not always clear to people that they had had a diagnosis; one woman for instance said that it had only been mentioned in passing that her heart wouldn’t get better and that she hadn’t taken much notice. Others described how doctors talked to them in detail about surgery and altering medication but didn’t give them an overview of heart failure.

He was not well enough to really understand his diagnosis.

Age at interview 82

Gender Male

Age at diagnosis 72

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She has not had a diagnosis of heart failure.

Age at interview 69

Gender Female

Age at diagnosis 64

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Describes her diagnosis of heart failure.

Age at interview 76

Gender Female

Age at diagnosis 74

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He was diagnosed with a tired heart and explains some of the difficulties he has had since.

Age at interview 81

Gender Male

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Vivienne was misdiagnosed at A&E after being taken there because of breathlessness. At A&E she had a chest x-ray and other tests that didn’t revealed anything wrong with her heart. Doctors thought that she probably had suffered a panic attack and sent her home. But she continued feeling breathless and fatigued and went to see her GP who is also a cardiologist (heart specialist). He recognised her symptoms as possible heart failure and referred her to see a consultant.

Vivienne was misdiagnosed at A&E but she knew there was something wrong with her and went to see her GP who is also a cardiologist.

Age at interview 61

Gender Female

Age at diagnosis 60

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Several people only recalled receiving a diagnosis of heart failure when they asked questions; one woman had been put on medication without realising what it was for and found out she had heart failure when she asked a doctor if she could stop taking it. Another man only realised he had heart failure when he saw a British Heart Foundation advertisement in a newspaper and asked his GP for confirmation. One woman who had waited 14 months to get a diagnosis said that heart failure cases should be dealt with more quickly.

She was told she had heart failure by a nurse in hospital.

Age at interview 53

Gender Female

Age at diagnosis 49

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A newspaper advertisement made him think he had heart failure.

Age at interview 74

Gender Male

Age at diagnosis 73

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She wonders why it takes so long to get a diagnosis of heart failure after tests.

Age at interview 65

Gender Female

Age at diagnosis 59

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The National Institute for Health and Clinical Excellence (NICE) have produced guidance about the diagnosis and treatment of heart failure which can be found on their website.

What is heart failure?

Heart failure happens when the heart does not pump blood round the body as well as it should. It is not a disease in itself...