Exploring symptoms in chronic heart failure
Abstract
Symptoms in patients with chronic heart failure (CHF) are the cry for help, reflecting not only the physical aspects of the disease but the impact on lifestyle, anxiety, depression and expectations of the patient. Studies consistently show a difference in patients' self-assessed functional classification compared to investigator reported NYHA classification. Moreover, patient self-assessed symptoms have recently been shown to independently predict hospitalisation and mortality over 5 years. Recognition of symptoms and appreciation of their importance justifies the use of a structured assessment in order to provide optimal medical care for patients with CHF. A model of how to structure symptom assessment equally with signs is presented in this paper.
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Fatigue could also be due to sleep disturbance due to anxiety, pain, orthopnoea, or paroxysmal nocturnal dyspnoea.
“However, fatigue could also be due to sleep disturbance due to anxiety, pain, orthopnoea, or paroxysmal nocturnal dyspnoea. 1 , 10 , 45”
From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [45]
Similar to fatigue, dyspnoea is often underappreciated and seen as a by-product of ageing and reduced fitness.
“Similar to fatigue, dyspnoea is often underappreciated and seen as a by‐product of ageing and reduced fitness. 45”
From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [45]
Breathlessness is often frightening and has a psychological impact.
“It is often frightening and has a psychological impact. 10 , 45 , 52 , 53”
From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [45]
Dyspnoea is thought to be due to a combination of factors including diaphragmatic or skeletal muscle weakness, deconditioning, obesity, anaemia, pulmonary oedema, or lung stiffness due to elevated left ventricular pressure.
“Dyspnoea is thought to be due to a combination of factors including diaphragmatic or skeletal muscle weakness, deconditioning, obesity, anaemia, pulmonary oedema, or lung stiffness due to elevated left ventricular pressure. 10 , 45 , 50”
From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [45]
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Wallström, S., Ali, L., Ekman, I., Swedberg, K. B., & Fors, A. (2019) · European Journal of Cardiovascular Nursing · doi:10.1177/1474515119891599 · Cited by 24 · see citing works
Kohlmann, S., Rimington, H., & Weinman, J. (2012) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2012.03.002 · Cited by 21 · see citing works
Shafazand, M., Patel, H., Ekman, I., Swedberg, K. B., & Schaufelberger, M. (2012) · BMC Research Notes · doi:10.1186/1756-0500-5-132 · Cited by 20 · see citing works
Caring about symptoms in person-centred care
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Ekman, I., Granger, B. B., Swedberg, K. B., Stenlund, H. C., & Boman, K. (2011) · European Journal of Heart Failure · doi:10.1093/eurjhf/hfr062 · Cited by 19 · see citing works
Wallström, S., Ulin, K., Ömerovic, E., & Ekman, I. (2016) · International Journal of Cardiology · doi:10.1016/j.ijcard.2016.09.052 · Cited by 19 · see citing works
Determinants of Depressive Symptoms in Hospitalised Men and Women with Heart Failure
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Gobeil, K., White, K., Bhat, A. G., Szalai, H., Lagu, T. C., & Pack, Q. R. (2020) · Heart & Lung · doi:10.1016/j.hrtlng.2020.12.006 · Cited by 18 · see citing works
Andersson, H., Ullgren, A., Holmberg, M., Karlsson, T., Herlitz, J. D., & Sundström, B. W. (2017) · International Emergency Nursing · doi:10.1016/j.ienj.2016.12.001 · Cited by 18 · see citing works
The Monocrotaline Rat Model of Right Heart Disease Induced by Pulmonary Artery Hypertension
Krstic, A. M., Jones, T. L. M., Power, A., & Ward, M. (2024) · Biomedicines · doi:10.3390/biomedicines12091944 · Cited by 17 · see citing works
Ekman, I., Wolf, A., Dickson, V. V., Bosworth, H. B., & Granger, B. B. (2017) · European Journal of Cardiovascular Nursing · doi:10.1177/1474515117707669 · Cited by 17 · see citing works
The Contribution of Depression and Spirituality to Symptom Burden in Chronic Heart Failure
Gusick, G. M. (2008) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2007.10.004 · Cited by 17 · see citing works
Cooper, T. J., Anker, S. D., Colet, J. C., Filippatos, G. S., Lainščak, M., Lüscher, T. F., Mori, C., Johnson, P. C., Ponikowski, P. P., & Dickstein, K. (2016) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2016.02.018 · Cited by 16 · see citing works
Symptoms in patients with takotsubo syndrome: a qualitative interview study
Wallström, S., Ulin, K., Ömerovic, E., & Ekman, I. (2016) · BMJ Open · doi:10.1136/bmjopen-2016-011820 · Cited by 16 · see citing works
Ghezeljeh, T. N., Momtahen, M., Tessma, M. K., Nikravesh, M. Y., Ekman, I., & Emami, A. (2010) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2009.12.021 · Cited by 15 · see citing works
Navigating Symptom Management in Heart Failure: The Crucial Role of the Critical Care Nurse
Vuckovic, K. M., Bierle, R., & Ryan, C. J. (2020) · Critical Care Nurse · doi:10.4037/ccn2020685 · Cited by 14 · see citing works
Bayer-Topilsky, T., Trenerry, M. R., Suri, R. M., Topilsky, Y., Antiel, R. M., Marmor, Y. N., Mahoney, D. W., Schaff, H. V., & Enriquez-Sarano, M. L. (2013) · The American Journal of Medicine · doi:10.1016/j.amjmed.2013.05.013 · Cited by 13 · see citing works
Palliative symptom management in patients with heart failure
Zambroski, C. H., & Bekelman, D. B. (2008) · Progress in Palliative Care · doi:10.1179/096992608x346206 · Cited by 13 · see citing works
Fredriksson‐Larsson, U., Alsén, P., & Brink, E. (2013) · International Journal of Qualitative Studies on Health and Well-Being · doi:10.3402/qhw.v8i0.20836 · Cited by 12 · see citing works
Supportive and palliative care for adults dying from congenital heart defect
Tobler, D., de Stoutz, N., & Greutmann, M. (2011) · Current Opinion in Supportive and Palliative Care · doi:10.1097/spc.0b013e3283492aa3 · Cited by 11 · see citing works
Adaptation and validation of the Iranian version of Angina Pectoris characteristics questionnaire
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Zahavi, D., & Kriegel, U. (2015) · Cited by 10 · see citing works
Arvanitaki, A., Michou, E., Kalogeropoulos, A. P., Karvounis, H. I., & Giannakoulas, G. A. (2020) · ESC Heart Failure · doi:10.1002/ehf2.12701 · Cited by 9 · see citing works
A Practical Use of Theory to Study Adherence
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Clinical Diagnosis of Left Ventricular Dilatation and Dysfunction in the Age of Technology
Rovai, D., Morales, M., Bella, G. D., NES, M. D., Pingitore, A., Lombardi, M., & Rossi, G. (2007) · European Journal of Heart Failure · doi:10.1016/j.ejheart.2007.02.002 · Cited by 9 · see citing works
Neo, S. H., Tan, J. Y.-T., Sim, D. K.-L., Ng, E. S.-L., Loh, J. K. X., Yang, G. M., Murtagh, F. E., & Cheung, Y. B. (2022) · Palliative Medicine Reports · doi:10.1089/pmr.2022.0029 · Cited by 8 · see citing works
Perceived Symptoms in People Living with Impaired Glucose Tolerance
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Patients with worsening chronic heart failure - Symptoms and aspects of care
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Person-centred care: Possibilities, barriers and effects in hospitalised patients
Wolf, A. (2012) · Gothenburg University Publications Electronic Archive (Gothenburg University) · Cited by 7 · see citing works
Patients with acute hip fractures; motivation, effectiveness and costs in two different care systems
Olsson, L. (2006) · Gothenburg University Publications Electronic Archive (Gothenburg University) · Cited by 7 · see citing works
Chung, W. Y., Lam, S., Pernari, B., Kim, Y., Cho, S., Burger, D. E., & Sweeney, G. (2025) · Mechanisms of Ageing and Development · doi:10.1016/j.mad.2025.112078 · Cited by 6 · see citing works
Pulmonary Oedema — A Life Threatening Disease
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Prospective Evaluation of Association Between Negative Emotions and Heart Failure Symptom Severity
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Waldréus, N. (2016) · Linköping University medical dissertations · doi:10.3384/diss.diva-126151 · Cited by 4 · see citing works
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Hedemalm, A. (2007) · Gothenburg University Publications Electronic Archive (Gothenburg University) · Cited by 4 · see citing works
Patient and health care delays in malignant melanoma
Hajdarević, S. (2012) · KTH Publication Database DiVA (KTH Royal Institute of Technology) · Cited by 4 · see citing works
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Lopatin, Y. M., Rosano, G. M. K., Fragasso, G., Lopashchuk, G. D., Seferovich, P. M., Goudac, L. H. V., Vinereanu, D., Hamid, M. A., Jourdain, P., & Ponikovsky, P. (2016) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2016-8-70-79 · Cited by 3 · see citing works
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- Authors
- Ekman, I., Cleland, J. G. F., Andersson, B., & Swedberg, K.
- Affiliations
- University of Gothenburg (SE)
- University of Hull (GB)
- Sahlgrenska University Hospital (SE)
- Corresponding author
- Ekman, Inger
- Venue
- European Journal of Heart Failure
- Publisher
- Oxford University Press (OUP)
- Published
- 2005-08-01
- Volume
- 7
- Issue
- 5
- Pages
- 699-703
- ISSN
- 1388-9842 (ISSN-L)
- 1879-0844
- OpenAlex
- W2023732292
- Cited by
- 135
- References
- 33
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 7 · 2023: 2 · 2022: 4 · 2021: 3 · 2020: 6 · 2019: 1 · 2018: 2 · 2017: 6 · 2016: 11 · 2015: 7 · 2014: 3 · 2013: 7 · 2012: 15
- FWCI
- 8.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Heart Failure (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart rate and cardiovascular health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- chronic heart failure, clinical symptoms, symptom assessment, NYHA functional class, patient expectations, anxiety, depression, hospitalization, mortality
- MeSH terms
- Dyspnea, Heart Failure, Humans, Patient Compliance
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