Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK.
School of Medicine, Keele University, Keele, UK.
Curr Heart Fail Rep. 2022 Aug;19(4):247-253. doi: 10.1007/s11897-022-00551-4. Epub 2022 Jun 6.
Missed opportunities are incidents where different actions by those involved could have resulted in more desirable events. Heart failure is a complex clinical syndrome presenting as symptoms and signs common to other diagnoses, in patients frequently with multiple co-morbidities. Heart failure itself is not a diagnosis, but is the common clinical presentation of a variety of cardiac conditions. Correct diagnosis involves amalgamation of the clinical presentation, the results of general and specific investigations, and the clinician's ability to synthesize the overall picture. It is not surprising therefore that misdiagnosis can occur at any level of the heart failure journey and can occur because of patient, clinician, and health economy related factors. Delayed diagnosis leads to excess morbidity and mortality in these patients. In this review, we define the pathways for diagnosis of heart failure and then highlight missed opportunities related to delay and misdiagnosis. In addition, we consider how the earlier opportunity may impact patients, clinicians and health services.
错失的机会是指相关人员采取不同的行动本来可以导致更理想的结果的情况。心力衰竭是一种复杂的临床综合征，表现为与其他诊断常见的症状和体征，患者常常伴有多种合并症。心力衰竭本身不是一种诊断，而是各种心脏疾病的常见临床表现。正确的诊断涉及临床表现的综合、一般和特殊检查的结果，以及临床医生综合整体情况的能力。因此，在心力衰竭的任何阶段都可能发生误诊也就不足为奇了，误诊可能是由于患者、临床医生和医疗经济相关因素造成的。延迟诊断会导致这些患者的发病率和死亡率增加。在这篇综述中，我们定义了心力衰竭的诊断途径，然后重点介绍了与延迟和误诊相关的错失的机会。此外，我们还考虑了早期机会如何影响患者、临床医生和卫生服务。
