About this Series

Cardiologists caring for patients with chronic heart failure face an unpredictable disease whose arsenal includes unexpected hospitalizations and sudden death. Yet, research shows that heart failure patients have unmet medical needs. In particular, 17% of patients with heart failure with reduced ejection fraction (HFrEF) see their condition worsen within a year and a half of diagnosis, but surveys show that eligible patients are often overlooked for medication changes or dose increases. Despite the availability of new and effective therapies, half of patients continue to die within 5 years of diagnosis.

One potential explanation for the disconnect is the reliance on patient-reported symptoms as evidence of disease progression—which they are not. The absence of apparent symptoms does not mean that a patient has stable ejection fraction. Rather, leading cardiologists contend that visible symptoms are often a harbinger of an imminent hospitalization or sudden cardiac death. They recommend initiating preventive treatment long before arriving at that point.

For heart failure patients, hospitalization is often an indicator that prognosis is poor. Between 20% and 25% will be readmitted to a hospital within 30 days of discharge. These hospitalizations place a tremendous burden and cost on the patient, his or her family, and the healthcare system. With that in mind, cardiologists strongly recommend that physicians reject the myth of the stable heart failure patient which gives life to the medical inertia preventing doctors from putting new therapies into use that could save many lives.

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