Cardiac impairment or heart failure?: What about "cardiovascular insufficiency syndrome"?

doi:10.1136/bmj.331.7516.577

BMJ 2005;331:577 (10 September), doi:10.1136/bmj.331.7516.577

Letter

Cardiac impairment or heart failure?

What about "cardiovascular insufficiency syndrome"?

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

EDITOR—As a non-clinical researcher currently engagedin a qualitative study of emotions and coping in chronic heartfailure, I welcome Lehman et al's editorial debating the label"heart failure."¹

At a recent meeting with a group of general practitioners theissues of communication between doctor and patient and the useof the term "heart failure" were the dominant feature. Not onlydoes failure, for patients, mean the end of hope but it alsocarries pejorative connotations of culpability, particularlyagainst the prevailing public health and health promotion background,which emphasises behaviour and lifestyle in the aetiology ofheart disease.

The complexity of heart failure can be viewed in many ways,depending on training and professional experience. Physiologistsidentify one common component across varieties of heart failureas the inability of the cardiovascular system, as a whole, tomaintain an adequate pressure gradient in the circulation. Obviously,many of . . . [Full text of this article]

J David Mitchell, researcher in health and medical sociology

Division of Primary Care, University of Liverpool, Liverpool L69 3GB jdavidm@liverpool.ac.uk