Related Experiment Videos
Signs and symptoms of heart failure: are you asking the right questions?
Nancy Albert1, Kathleen Trochelman, Jianbo Li
1Nursing Institute at Cleveland Clinic in Cleveland, Ohio 44195, USA. albertn@ccf.org
Background:
Patients may not verbalize common and atypical signs and symptoms of heart failure and may not understand their association with worsening disease and treatments.
Objectives:
To examine prevalence of signs and symptoms relative to demographics, care setting, and functional class.
Methods:
A convenience sample of 276 patients (164 ambulatory, 112 hospitalized) with systolic heart failure completed a 1-page checklist of signs and symptoms experienced in the preceding 7 days (ambulatory) or in the 7 days before hospitalization. Demographic and medical history data were collected.
Results:
Mean age was 61.6 (SD, 14.8) years, 65% were male, 58% were white, and 45% had ischemic cardiomyopathy. Hospitalized patients reported more sudden weight gain, weight loss, severe cough, low/orthostatic blood pressure, profound fatigue, decreased exercise, restlessness/confusion, irregular pulse, and palpitations (all P < .05). Patients in functional class IV reported more atypical signs and symptoms of heart failure (severe cough, nausea/vomiting, diarrhea or loss of appetite, and restlessness, confusion, or fainting, all P
Conclusion:
Profound fatigue is more reliable than dyspnea as an indicator of functional class. Nurses must recognize atypical signs and symptoms of worsening functional class to determine clinical status and facilitate patient care decisions.
Related Concept Videos
Heart Failure III: Clinical Manifestations
Heart Failure VII: Nursing Interventions
Pathophysiology of Heart Failure
Heart Failure IV: Classification and Diagnostic Evaluation
Heart Failure I: Introduction
Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...