Heart failure may go unrecognized among some patients

Reported by Susan Aldridge, PhD, medical journalist

Some cases of heart failure are not being picked up in the emergency room, according to a study from Canada.
Heart failure is generally linked with what is known as a lowered ejection fraction. That is, the percentage of blood leaving the heart with each beat is less than it needs to be. This arises from an enlarged heart, which means the heart muscle is weakened and cannot pump blood efficiently. However, according to researchers at the Canadian Institutes of Health Research, some people have a different type of heart failure, which is harder to diagnose.

They looked at nearly 3,000 patients admitted to hospitals in Ontario who were eventually diagnosed with heart failure. A third of them had normal ejection fraction. This is because they had diastolic heart failure, which occurs when the heart does not fill up with enough blood in the first place. The other kind, associated with an enlarged heart, is called systolic heart failure. The researchers say the incidence of diastolic heart failure is increasing. It is more common among older patients and among women. It is also linked to high blood pressure and diabetes. Further analysis of the Ontario data showed that the death rates at 30 days and one year were similar for those with systolic and diastolic heart failure. Therefore, there is an urgent need to find better ways of diagnosing and treating diastolic heart failure.

Source
Canadian Institutes of Health Research 10th January 2007

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