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Cited by 107Heart Failure Treatment and ManagementCardiovascular Function and Risk FactorsHeart rate and cardiovascular health

The DOI matches its Crossref record; 38 of the 38 references it cites were found in a registry or an index.

Signs and Symptoms of Heart Failure: Are You Asking the Right Questions?

Albert, Nancy, Trochelman, Kathleen, Li, Jianbo, Lin, Songhua·2010·American Journal of Critical Care
DOI 10.4037/ajcc2009314
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Abstract

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 <or= .001). Sudden weight gain increased from 5% in functional class I to 37.5% in functional class IV (P < .001). Dyspnea occurred in all functional classes (98%-100%) and both settings (92%-100%). Profound fatigue was associated with worsening functional class (P < .001) and hospital setting (P = .001); paroxysmal nocturnal dyspnea was associated with functional class IV (P = .02) and hospital setting (P < .001). 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.

Overview

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Crossref · 10.4037/ajcc2009314

Cites

38 of 38 references verified0 citation errors · 0 not checkable

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  • Many patients have little appreciation of the significance or the knowledge of how to adjust their diuretic dose.

    “Many patients have little appreciation of the significance or the knowledge of how to adjust their diuretic dose. 63 , 78 , 79”

    From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [63]

  • Persistent cough causes breathlessness, fatigue, and chest pain, disrupting activity and sleep.

    “Persistent cough causes breathlessness, fatigue, and chest pain, disrupting activity and sleep. 1 , 18 , 63”

    From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [63]

  • Patients often fail to appreciate mild peripheral oedema due to its insidious development and mistake it for normal weight gain, such that oedema may not be reported until 20 L of fluid has accumulated.

    “Unfortunately, patients often fail to appreciate mild peripheral oedema due to its insidious development and mistake it for normal weight gain 63 , 78 such that oedema may not be reported until 20 L of fluid has accumulated.”

    From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [63]

  • Peripheral swelling is included in most symptom questionnaires because weight gain can be masked by cachexia.

    “Peripheral swelling is included in most symptom questionnaires because weight gain can be masked by cachexia. 63”

    From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [63]

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  1. Leventhal, 1980, The common-sense representation of illness danger, 7

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Metadata

Authors
Albert, N., Trochelman, K., Li, J., & Lin, S.
Affiliations
Cleveland Clinic (US)
Corresponding author
Albert, Nancy
ORCID
Venue
American Journal of Critical Care
Publisher
AACN Publishing
Published
2010-09-01
Volume
19
Issue
5
Pages
443-452
ISSN
  • 1062-3264 (ISSN-L)
  • 1937-710X
DOI
10.4037/ajcc2009314
OpenAlex
W2172000453
Cited by
101
References
37
Citations by year
2026: 5 · 2025: 7 · 2024: 10 · 2023: 2 · 2022: 6 · 2021: 10 · 2020: 5 · 2019: 8 · 2018: 9 · 2017: 9 · 2016: 8 · 2015: 6 · 2014: 7 · 2013: 7 · 2012: 2
FWCI
0.43
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Critical Care (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart rate and cardiovascular health
Keywords
heart failure with reduced ejection fraction, signs and symptoms, functional class, dyspnea, paroxysmal nocturnal dyspnea, hospitalized patients, outpatients, nursing assessment
MeSH terms
Aged, Cross-Sectional Studies, Dyspnea, Fatigue, Female, Humans, Inpatients, Male, Middle Aged, Outpatients, Severity of Illness Index, Heart Failure, Systolic, Checklist, Self Report

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