From breathless to failure: symptom onset and diagnostic meaning in patients with heart failure - a qualitative study

C.J. Taylor, F.D.R. Hobbs, T. Marshall, F. Leyva-Leon, N. Gale

Research output: Contribution to journalArticlepeer-review


Objectives: To explore 2 key points in the heart failure diagnostic pathway-symptom onset and diagnostic meaning-from the patient perspective. Design: Qualitative interview study. Setting: Participants were recruited from a secondary care clinic in central England following referral from primary care. Participants: Over age 55 years with a recent (<1 year) diagnosis of heart failure confirmed by a cardiologist following initial presentation to primary care. Methods: Semistructured interviews were carried out with 16 participants (11 men and 5 women, median age 78.5 years) in their own homes. Data were audiorecorded and transcribed. Participants were asked to describe their diagnostic journey from when they first noticed something wrong up to and including the point of diagnosis. Data were analysed using the framework method. Results: Participants initially normalised symptoms and only sought medical help when daily activities were affected. Failure to realise that anything was wrong led to a delay in help-seeking. Participants' understanding of the term 'heart failure' was variable and 1 participant did not know he had the condition. The term itself caused great anxiety initially but participants learnt to cope with and accept their diagnosis over time. Conclusions: Greater public awareness of symptoms and adequate explanation of 'heart failure' as a diagnostic label, or reconsideration of its use, are potential areas of service improvement.

Original languageEnglish
Article number013648
Number of pages9
JournalBMJ Open
Issue number3
Publication statusPublished - 10 Mar 2017

Bibliographical note

© The authors. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work noncommercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:


Dive into the research topics of 'From breathless to failure: symptom onset and diagnostic meaning in patients with heart failure - a qualitative study'. Together they form a unique fingerprint.

Cite this