Pain and Heart Failure: Unrecognized and Untreated

Overview

Journal Eur J Cardiovasc Nurs

Publisher Oxford University Press

Specialties Cardiology & Vascular Diseases
Nursing

Date 2009 Jan 20

PMID 19150255

Citations 24

Authors

Lorraine S Evangelista

Erin Sackett

Kathleen Dracup

Affiliations

Soon will be listed here.

Abstract

Background: Although evidence exists to support the presence of pain in advanced stages of heart failure (HF), the pain experience in the early phases of this progressive disease is poorly documented, and therefore, poorly understood. The current study was conducted to: 1) examine the prevalence of pain in cohort of patients with chronic HF (New York Heart Association class I-IV); and 2) determine the relationship between pain and QOL.

Methods And Results: Data were obtained from 300 patients (mean age 54.2+/-12.7 years; 72% male; 65% Caucasians; time since HF diagnosis 4.6+/-4.8 years). Two-thirds of the patients (67%) reported some degree of pain; the prevalence of pain increased as functional class worsened (p<.009). Differences in QOL outcomes for patients experiencing pain vs. no pain were statistically significant for physical and overall QOL. Pain accounted for 20% of the variance in QOL (p<.001) even after adjusting for age, gender, and functional class.

Conclusions: Our findings suggest pain is present in a majority of patients with HF. Given the potential deleterious effects of untreated pain on QOL in patients with HF, it is important that healthcare providers assess patients for this often-unrecognized symptom.

Citing Articles

How to deliver person-centred care for people living with heart failure: a multi stakeholder interview study with patients, caregivers and healthcare professionals in Thailand.

Giusti A, Pukrittayakamee P, Wannarit K, Thongchot L, Janwanishstaporn S, Nkhoma K BMC Health Serv Res. 2024; 24(1):1570.

PMID: 39696212 PMC: 11654141. DOI: 10.1186/s12913-024-11922-z.

Pain and Heart Failure During Transport by Emergency Medical Services and Its Associated Outcomes: Hospitalization, Mortality, and Length of Stay.

Smith A, Jung M, Pressler S West J Nurs Res. 2024; 46(3):172-182.

PMID: 38230416 PMC: 10922995. DOI: 10.1177/01939459231223128.

Pain sensation and gut microbiota profiles in older adults with heart failure.

Chen J, Wang Z, Starkweather A, Chen M, McCauley P, Miao H Interdiscip Nurs Res. 2023; 2(2):83-91.

PMID: 37645375 PMC: 10461724. DOI: 10.1097/NR9.0000000000000024.

Characterizing Pain Leading to Emergency Medical Services Activation in Heart Failure.

Smith A, Jung M, Lee C, Pressler S J Cardiovasc Nurs. 2021; 37(5):427-436.

PMID: 34954742 PMC: 9218008. DOI: 10.1097/JCN.0000000000000878.

Palliative Care for People Living With Heart Disease-Does Sex Make a Difference?.

Sobanski P, Krajnik M, Goodlin S Front Cardiovasc Med. 2021; 8:629752.

PMID: 33634172 PMC: 7901984. DOI: 10.3389/fcvm.2021.629752.

References

Rector T, Ormaza S, Kubo S . Health status of heart transplant recipients versus patients awaiting heart transplantation: a preliminary evaluation of the SF-36 questionnaire. J Heart Lung Transplant. 1993; 12(6 Pt 1):983-6. View

Azevedo A, Bettencourt P, Alvelos M, Martins E, Abreu-Lima C, Hense H . Health-related quality of life and stages of heart failure. Int J Cardiol. 2007; 129(2):238-44. DOI: 10.1016/j.ijcard.2007.07.091. View

Bekelman D, Havranek E, Becker D, Kutner J, Peterson P, Wittstein I . Symptoms, depression, and quality of life in patients with heart failure. J Card Fail. 2007; 13(8):643-8. DOI: 10.1016/j.cardfail.2007.05.005. View

Akbas M, Oztunc G . Examination of knowledge about and nursing interventions for the care of patients in pain of nurses who work at Cukurova University medical faculty Balcali hospital. Pain Manag Nurs. 2008; 9(3):88-95. DOI: 10.1016/j.pmn.2008.02.004. View

Heart Failure Society Of America . HFSA 2006 Comprehensive Heart Failure Practice Guideline. J Card Fail. 2006; 12(1):e1-2. DOI: 10.1016/j.cardfail.2005.11.005. View

Godfrey C, Harrison M, Medves J, Tranmer J . The symptom of pain with heart failure: a systematic review. J Card Fail. 2006; 12(4):307-13. DOI: 10.1016/j.cardfail.2006.01.006. View

Mann D . Mechanisms and models in heart failure: A combinatorial approach. Circulation. 1999; 100(9):999-1008. DOI: 10.1161/01.cir.100.9.999. View

Borson S, Scanlan J, Chen P, Ganguli M . The Mini-Cog as a screen for dementia: validation in a population-based sample. J Am Geriatr Soc. 2003; 51(10):1451-4. DOI: 10.1046/j.1532-5415.2003.51465.x. View

Hauptman P, Goodlin S, Lopatin M, Costanzo M, Fonarow G, Yancy C . Characteristics of patients hospitalized with acute decompensated heart failure who are referred for hospice care. Arch Intern Med. 2007; 167(18):1990-7. DOI: 10.1001/archinte.167.18.1990. View

10.

Butt Z, Wagner L, Beaumont J, Paice J, Peterman A, Shevrin D . Use of a single-item screening tool to detect clinically significant fatigue, pain, distress, and anorexia in ambulatory cancer practice. J Pain Symptom Manage. 2007; 35(1):20-30. DOI: 10.1016/j.jpainsymman.2007.02.040. View

11.

Ammar K, Jacobsen S, Mahoney D, Kors J, Redfield M, Burnett Jr J . Prevalence and prognostic significance of heart failure stages: application of the American College of Cardiology/American Heart Association heart failure staging criteria in the community. Circulation. 2007; 115(12):1563-70. DOI: 10.1161/CIRCULATIONAHA.106.666818. View

12.

Fonarow G, Yancy C, Albert N, Curtis A, Stough W, Gheorghiade M . Improving the use of evidence-based heart failure therapies in the outpatient setting: the IMPROVE HF performance improvement registry. Am Heart J. 2007; 154(1):12-38. DOI: 10.1016/j.ahj.2007.03.030. View

13.

. Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms. Prepared by the International Association for the Study of Pain, Subcommittee on Taxonomy. Pain Suppl. 1986; 3:S1-226. View

14.

Walke L, Byers A, McCorkle R, Fried T . Symptom assessment in community-dwelling older adults with advanced chronic disease. J Pain Symptom Manage. 2006; 31(1):31-7. DOI: 10.1016/j.jpainsymman.2005.05.014. View

15.

Cohn J . Structural basis for heart failure. Ventricular remodeling and its pharmacological inhibition. Circulation. 1995; 91(10):2504-7. DOI: 10.1161/01.cir.91.10.2504. View

16.

Borson S, Scanlan J, BRUSH M, Vitaliano P, Dokmak A . The mini-cog: a cognitive 'vital signs' measure for dementia screening in multi-lingual elderly. Int J Geriatr Psychiatry. 2000; 15(11):1021-7. DOI: 10.1002/1099-1166(200011)15:11<1021::aid-gps234>3.0.co;2-6. View

17.

Rector T, Johnson G, Dunkman W, Daniels G, Farrell L, Henrick A . Evaluation by patients with heart failure of the effects of enalapril compared with hydralazine plus isosorbide dinitrate on quality of life. V-HeFT II. The V-HeFT VA Cooperative Studies Group. Circulation. 1993; 87(6 Suppl):VI71-7. View

18.

Uddin N, Patterson J . Current guidelines for treatment of heart failure: 2006 update. Pharmacotherapy. 2007; 27(4 Pt 2):12S-17S. DOI: 10.1592/phco.27.4part2.12S. View

19.

Goldman L, Hashimoto B, Cook E, Loscalzo A . Comparative reproducibility and validity of systems for assessing cardiovascular functional class: advantages of a new specific activity scale. Circulation. 1981; 64(6):1227-34. DOI: 10.1161/01.cir.64.6.1227. View

20.

Walke L, Byers A, Tinetti M, Dubin J, McCorkle R, Fried T . Range and severity of symptoms over time among older adults with chronic obstructive pulmonary disease and heart failure. Arch Intern Med. 2007; 167(22):2503-8. PMC: 2196402. DOI: 10.1001/archinte.167.22.2503. View