Cardiologists warn that heart failure can hide behind a “normal” test result

A heart test can show that the organ pumps blood normally and still fail to rule out heart failure, according to a new international cardiology consensus.

The document, published in the journal Circulation, was prepared by the American Heart Association, World Heart Federation, American College of Cardiology and European Society of Cardiology. It represents the second attempt in five years to establish a common approach to defining the condition.

“

Definitions are really very important for patients.

The groups say doctors should move away from relying too heavily on ejection fraction, the percentage of blood the heart pushes out with each beat. The measurement can help diagnose heart failure, but it cannot by itself confirm or exclude the disease. Heart imaging, blood tests and genetic testing should also be considered.

“Definitions are really very important for patients,” said cardiologist Mary Norine Walsh, co-chair of the group that produced the consensus document, in a Circulation podcast. She said the new definition “provides a clearer and more consistent framework” for doctors and patients.

“

Provides a clearer and more consistent framework.

Heart failure is a clinical condition caused by a structural or functional abnormality that disrupts the heart’s ability to pump blood or fill with it. It can change over time and appear differently from one person to another. The condition affects more than 55 million people and is the world’s leading cause of hospitalization, while differing definitions across countries and medical organizations have complicated diagnosis and classification.

The World Heart Federation has identified limited awareness as a major barrier for patients, families, communities, health workers and policymakers. Walsh said the push to move away from rigid ejection-fraction thresholds was somewhat controversial, but argued that earlier rules had restricted thinking about the disease’s underlying pathology.

“

We really recommended moving away from rigid measurement of ejection fraction.