Copyright © 1991 by the European Society of Cardiology.
© 1991 The European Society of Cardiology
Validity of clinical diagnosis of heart failure in primary health care
*Kuopio University Central Hospital, Department of Medicine Kuopio
Research Institute for Social Security, Social Insurance Institution Helsinki, Finland
Received 18 March 1990; revised 17 April 1990; .
Correspondence: Jouko Remes, MD, Department of Medicine, Kuopto University Central Hospital, SF-70210 Kuopio, Finland.
Abstract
Validity of heart failure (HF) diagnosis was studied in 88 patients (37 men and 51 women), aged 45.74 (mean 61) years, in whom HF diagnosis had been newly made by primary health care physicians. Boston criteria for HF and a supplementary classification, based on information from clinicial examinations and a 6-month follow-up, were used to define HF diagnosis as ‘definite’, ‘possible’ or ‘unlikely’. Twenty-eight (32%) patients (21 men and seven women) had ‘definite’ HF and 46 (52%) (28 men and 18 women) had either ‘definite’ or ‘possible’HF by both classifications. In 30 (34%) patients (six men and 24 women) HF diagnosis was ‘unlikely’by both classifications.
In conclusion, false-positive diagnosis of HF was common in primary health care, and HF diagnosis was more difficult in women than in men. Obesity, unrecognized symptomatic myocardial ischaemia without HF and pulmonary diseases were the most important conditions leading to false-positive HF diagnosis.
Key Words: Heart failure • diagnosis • obesity • primary health care • validity
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J.G.F. Cleland, A. Khand, and A. Clark The heart failure epidemic: exactly how big is it? Eur. Heart J., April 2, 2001; 22(8): 623 - 626. [PDF]
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P Hedberg, I Lonnberg, T Jonason, G Nilsson, K Pehrsson, and I Ringqvist Left ventricular systolic dysfunction in 75-year-old men and women. A population-based study Eur. Heart J., April 2, 2001; 22(8): 676 - 683. [Abstract] [PDF]
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S. Johansson, M.-A. Wallander, A. Ruigomez, and L. A. G. Rodriguez Incidence of newly diagnosed heart failure in UK general practice Eur J Heart Fail, March 1, 2001; 3(2): 225 - 231. [Abstract] [Full Text] [PDF]
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A. Owen and S. Cox Diagnosis of heart failure in elderly patients in primary care Eur J Heart Fail, January 1, 2001; 3(1): 79 - 81. [Abstract] [Full Text] [PDF]
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K. F. Fox, M. R. Cowie, D. A. Wood, A. J.S. Coats, P. A. Poole-Wilson, and G. C. Sutton A Rapid Access Heart Failure Clinic provides a prompt diagnosis and appropriate management of new heart failure presenting in the community Eur J Heart Fail, December 1, 2000; 2(4): 423 - 429. [Abstract] [Full Text] [PDF]
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J. Mason, P. Young, N. Freemantle, and R. Hobbs Safety and costs of initiating angiotensin converting enzyme inhibitors for heart failure in primary care: analysis of individual patient data from studies of left ventricular dysfunction BMJ, November 4, 2000; 321(7269): 1113 - 1116. [Abstract] [Full Text]
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F.D.R Hobbs, M.I Jones, T.F Allan, S Wilson, and R Tobias European survey of primary care physician perceptions on heart failure diagnosis and management (Euro-HF) Eur. Heart J., November 2, 2000; 21(22): 1877 - 1887. [Abstract] [PDF]
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F D R. Hobbs Modern management of hypertension and heart failure: evidence and practice Heart, September 1, 2000; 84(90001): 35i - 38. [Full Text]
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L. Caruana, M. C Petrie, A. P Davie, and J. J V McMurray Do patients with suspected heart failure and preserved left ventricular systolic function suffer from "diastolic heart failure" or from misdiagnosis? A prospective descriptive study BMJ, July 22, 2000; 321(7255): 215 - 218. [Abstract] [Full Text]
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J.G.F. Cleland, K. Swedberg, A. Cohen-Solal, J. Cosin-Aguilar, R. Dietz, F. Follath, A. Gavazzi, R. Hobbs, J. Korewicki, H.C. Madeira, et al. The Euro Heart Failure Survey of The EUROHEART Survey Programme: A survey on the quality of care among patients with heart failure in Europe Eur J Heart Fail, June 1, 2000; 2(2): 123 - 132. [Abstract] [Full Text] [PDF]
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R. S. Vasan and D. Levy Defining Diastolic Heart Failure : A Call for Standardized Diagnostic Criteria Circulation, May 2, 2000; 101(17): 2118 - 2121. [Full Text] [PDF]
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H Smith, R M Pickering, A Struthers, I Simpson, and D Mant Biochemical diagnosis of ventricular dysfunction in elderly patients in general practice: observational study BMJ, April 1, 2000; 320(7239): 906 - 908. [Abstract] [Full Text]
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T. F Luscher Diagnosis of CHF -- often a trap In Itself Journal of Renin-Angiotensin-Aldosterone System, March 1, 2000; 1(1_suppl): 7 - 11. [Abstract] [PDF]
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T. J. Noble, A. H. Morice, K. S. Channer, P. Milnes, N. D. Harris, and B. H. Brown Monitoring patients with left ventricular failure by electrical impedance tomography Eur J Heart Fail, December 17, 1999; 1(4): 379 - 384. [Abstract] [Full Text] [PDF]
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M. Mejhert, J. Holmgren, P. Wandell, H. Persson, and M. Edner Diagnostic tests, treatment and follow-up in heart failure patients -- is there a gender bias in the coherence to guidelines? Eur J Heart Fail, December 17, 1999; 1(4): 407 - 410. [Abstract] [Full Text] [PDF]
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M Piepoli Editorials: Diagnostic and prognostic indicators in chronic heart failure Eur. Heart J., October 1, 1999; 20(19): 1367 - 1369. [PDF]
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 P. M. Diller, D. R. Smucker, B. David, and R. J. Graham Congestive Heart Failure Due to Diastolic or Systolic Dysfunction: Frequency and Patient Characteristics in an Ambulatory Setting Arch Fam Med, September 1, 1999; 8(5): 414 - 420. [Abstract] [Full Text] [PDF]
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The Study Group on Diagnosis of the Working Group Increasing awareness and improving the management of heart failure in Europe: the IMPROVEMENT of HF initiative Eur J Heart Fail, June 1, 1999; 1(2): 139 - 144. [Abstract] [Full Text] [PDF]
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K.M. English and K.S. Channer How patients with heart failure are managed in the United Kingdom Eur J Heart Fail, June 1, 1999; 1(2): 201 - 202. [Abstract] [Full Text] [PDF]
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M. C. Petrie, N. F. Dawson, D. R. Murdoch, A. P. Davie, and J. J. V. McMurray Failure of Women's Hearts Circulation, May 4, 1999; 99(17): 2334 - 2341. [Full Text] [PDF]
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R. Willenheimer, B. Israelsson, C. Cline, E. Rydberg, K. Broms, and L. Erhardt Left atrioventricular plane displacement is related to both systolic and diastolic left ventricular performance in patients with chronic heart failure Eur. Heart J., April 2, 1999; 20(8): 612 - 618. [Abstract] [PDF]
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