[Perceptions of heart failure diagnosis and management: comparison between clinical cardiologists and family doctors].
OBJECTIVE
To compare the perceptions of heart failure (HF) diagnosis and management between clinical cardiologists (CC) and family doctors (FD) in the city of Niterói.


METHODS
A qualitative questionnaire, validated by the EURO-HF study, was submitted to 54 FD and 62 CC. These professionals supplied the following information: HF diagnosis; availability of complementary tests; which tests were used more often; names, dosages and adverse effects of the medications prescribed; and which pharmaceuticals reduced mortality.


RESULTS
FD and CC reported that the most common signs and symptoms identified by HF patients were: dyspnea, edema and fatigue (96.3% vs. 100%, 74% vs. 58% and 22.2% vs. 67.7%). The HF classification method used most often by FD was mild/moderate/severe (53.8%) while the CC used the NYHA method (72.7%) more often. CC request echocardiograms more often than FD (p < 0.001). CC differentiate HF with preserved systolic function from HF with systolic dysfunction more often than FD (p < 0.001). CC use beta-blockers (p < 0.001), angiotensin-converting enzyme inhibitors (p < 0.001) and spironolactone (p < 0.001) more often than FD. The angiotensin-converting enzyme (ACE) inhibitor dosages used by CC are greater than those used by FD (p < 0.001) and the spironolactone dosages used by CC are closer to those recommended in medical literature.


CONCLUSIONS
CC use a more intensive investigative diagnosis and medications that are more effective in reducing morbidity and mortality rates for HF patients.
Tavares
Leandro Reis
LR
Universidade Federal Fluminense e Projeto Médico da Família, FMS, Niterói, RJ. lreistavares@uol.com.br
Velarde
Luis Guilhermo Cocca
LG
de Miranda
Verônica Alcoforado
VA
Mesquita
Evandro Tinoco
ET
D000328:Adult; D001291:Attitude of Health Personnel; D002303:Cardiac Output, Low / Q000175:diagnosis* / Q000188:drug therapy; D002309:Cardiology; D002983:Clinical Competence; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D011787:Quality of Health Care; D011795:Surveys and Questionnaires