Reasons for seeking acute care in chronic heart failure

Background: Patients with chronic heart failure (CHF) have frequent episodes of exacerbation leading to recurrent hospitalization. Aims: To explore factors related to patients seeking care for worsening CHF. Methods: Eighty-eight patients diagnosed with a deteriorating CHF condition were interviewed. Data were analysed using content analysis. Results: Overall, 51 (58%) patients sought emergency care because of their symptoms while 37 (42%) were either sent by relatives or referred from outpatient clinics. Delay in seeking care was explained by 62 (71%) patients as a wait and see strategy, 9 (10%) were reluctant to use the health care system and 10 (11%) felt that it was futile to seek care. Fifty percent of the patients were uncertain about their current deteriorating status. Only 4 patients reported their symptoms to be related to heart failure. Conclusions: Although symptoms were the dominant reason for seeking emergency care, only a few patients related their symptoms to worsening CHF, which might be an important factor for not seeking emergency care earlier. Patient education programs should make efforts to improve understanding of symptom recognition. (C) 2006 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.