Cardiac impairment or heart failure?: "Impairment" is no less alarming or confusing than "failure"

doi:10.1136/bmj.331.7516.577-a

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

Letter

Cardiac impairment or heart failure?

"Impairment" is no less alarming or confusing than "failure"

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EDITOR—Lehman et al consider the term "heart failure"to be imprecise and confusing, preferring "cardiac impairment."¹

However, the term "cardiac impairment" is as vague and blurred.It is not more descriptive or less confusing. Impairment alsocovers a wide spectrum or continuum. Paradoxically, it may notreflect the seriousness of the diagnosis, especially in latestages of heart failure when the prognosis may be more seriousthan that for many malignancies.

Whatever term is used, doctors can avoid confusion by explainingthat failure, like many things in life and medicine, is a spectrum,and it does not mean the end. Also patients should be giventime and encouragement to ask questions and air fears and concerns.

Atef Michael, specialist registrar

Queen's Hospital, Burton on Trent DE15 0AR a.michael2@ukonline.co.uk

Competing interests: None declared.