Gender makes a difference in the description of dyspnoea in patients with chronic heart failure.
BACKGROUND
Dyspnoea is a common symptom of chronic heart failure (CHF). In the community setting, patients with CHF are most often women.


OBJECTIVE
To examine the impact of gender on the description of dyspnoea and to explore which clinical variables support a diagnosis of CHF.


METHODS
From four primary health care centres, 158 patients with CHF were included. Patients were examined with echocardiography and a cardiologist assessed the diagnosis of CHF. The patients filled in a questionnaire containing 11 descriptors of dyspnoea.


RESULTS
A diagnosis of CHF was confirmed in 87 (55%) patients (47 males and 40 females). One descriptor, I feel that I am suffocating, was significantly scored higher in CHF patients (p=0.014) as compared to non-CHF patients. Three descriptors, My breath does not go in all the way (p=0.006), I feel that I am suffocating (p=0.040), and I cannot get enough air (p=0.0327) were significantly scored higher among men with CHF, compared to no descriptor among women with CHF. Being male (OR=2.7; CI: 1.3-5.6, p=0.008), having diabetes (OR=5.6; CI: 1.7-18.2, p=0.004), IHD (OR=3.3; CI: 1.3-8.5, p=0.014), and a borderline significance for age (OR=1.04; CI: 0.99-1.08, p=0.058) predicted a confirmed diagnosis of CHF.


CONCLUSIONS
Three descriptors of dyspnoea were associated with CHF among men, whereas no such association was found among women. Our results suggest that gender is an important factor and should-together with age, underlying heart disease, and diabetes-be taken into account when symptoms are evaluated in the diagnosis of CHF in primary care.
Ekman
Inger
I
Faculty of Health and Caring Sciences, Institute of Nursing, The Sahlgrenska Academy at Göteborg University, Box 457, Göteborg SE 405 30, Sweden. inger.ekman@fhs.gu.se
Boman
Kurt
K
Olofsson
Mona
M
Aires
Nibia
N
Swedberg
Karl
K
D000367:Age Factors; D000368:Aged; D000787:Angina Pectoris / Q000150:complications; D001294:Attitude to Health; D016022:Case-Control Studies; D048909:Diabetes Complications / Q000150:complications; D004417:Dyspnea / Q000209:etiology / Q000523:psychology*; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000145:classification / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D006973:Hypertension / Q000150:complications; D016015:Logistic Models; D008297:Male; D008487:Medical History Taking; D008571:Men / Q000523:psychology*; D009203:Myocardial Infarction / Q000150:complications; D011237:Predictive Value of Tests; D011320:Primary Health Care; D012660:Semantics; D012720:Severity of Illness Index; D012727:Sex Characteristics; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D011795:Surveys and Questionnaires; D013548:Sweden; D014930:Women / Q000523:psychology*