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The Definition of Heart Failure
Article Number: SIS251463AI300425
30th April, 2025
Author(s):
Jason Gurney
Abstract:
BACKGROUND
Heart failure is a major public health problem, affecting more than 64 million people (1 to 3% of the general adult population worldwide). And its impact is not shared equally: in New Zealand, for instance, rates among Indigenous Māori are four to six times those among New Zealanders of European descent.
METHODS
This perspective examines the implications of the term "heart failure" through a personal narrative. The author’s mother was diagnosed with heart failure after presenting with symptoms including atrial fibrillation, tachycardia, and a reduced left ventricular ejection fraction (35%). Despite clinical improvement, the term "heart failure" caused significant distress, leading to self-blame and fear of imminent death.
RESULTS
The term "heart failure" carries unintended connotations of personal failure and mortality, which are often inaccurate for chronic, manageable conditions. The author highlights that similar conditions (e.g., diabetes, cancer) are not labeled with the word "failure," and proposes alternatives like "heart impairment" or "heart insufficiency" (the latter used in Germany). Patient surveys and focus groups could guide a transition to more accurate and less stigmatizing terminology.
CONCLUSIONS
Renaming "heart failure" could improve patient experiences by reducing stigma and aligning terminology with the chronic, manageable nature of the condition. A phased approach starting with patient-facing language (e.g., clinic names, discharge summaries) is recommended