Skip to main content

Research Repository

Advanced Search

Missed Opportunities in the Diagnosis of Heart Failure: Evaluation of Pathways to Determine Sources of Delay to Specialist Evaluation.

Satchithananda, D; Kwok, CS; Burke, H; McDermott, S; Welsh, V; Patwala, A; Barker, D; Mallen, C; Duckett, S


D Satchithananda

CS Kwok

H Burke

S McDermott

V Welsh

A Patwala

D Barker

C Mallen

S Duckett


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.

Acceptance Date Apr 25, 2022
Publication Date Jun 6, 2022
Journal Current Heart Failure Reports
Print ISSN 1546-9530
Publisher Springer Verlag
Keywords heart failure; diagnosis; pathways; missed opportunities
Publisher URL