A new report has identified a major gender gap when it comes to the diagnosis of heart failure.

According to the findings, women in Ireland have to wait, on average, five weeks before receiving a formal diagnosis compared to three weeks for men.

Women are also more likely to delay seeking help from healthcare professionals when they first develop symptoms. They tend to make appointments around four weeks later, which is almost twice as long as males.

Heart failure is a condition where the heart does not work as efficiently as it should, which means that the blood cannot deliver enough oxygen and nourishment to the body to allow it to work normally. Symptoms include fatigue, shortness of breath and swollen ankles.

The new report, State of the Heart: Examining the current state of heart failure diagnosis and care in Ireland, was launched by the Irish Heart Foundation and Roche Diagnostics. It includes an analysis of data from a first of its kind survey of 372 heart failure patients in Ireland.

The survey clearly shows the impact heart failure can have on people’s lives and highlights the toll a late diagnosis can take. Some 72% said that their lives would have been better if they had received their diagnosis earlier.

Mental health is the most identified negative impact of a delayed diagnosis, with 70% of respondents stating that their emotional wellbeing or mental health was affected. Females experienced a greater mental health impact than males – 73% versus 69%.

Meanwhile, 58% said that a delayed diagnosis had impacted their ability to work, resulting in financial losses.

A delayed diagnosis was also found to impact personal relationships, with 39% of women and 25% of men stating that their relationship with their partner was negatively impacted.

Furthermore, the report also highlighted a general lack of knowledge about heart failure. While waiting to receive a final diagnosis, 37% said they did not understand their prognosis. Again, this was higher among women (43%) compared to men (35%).

The report recommends increased education for the general public on the symptoms of heart failure to support earlier detection of the condition. However, it also acknowledges that heart failure can be difficult to diagnose and healthcare professionals need access to the right tools to make an accurate diagnosis.

Measuring natriuretic peptide levels provides healthcare professionals with the information they need to identify a potential case of heart failure, or rapidly rule it out. However, until recently, GPs in Ireland did not have access to these tests, such as NT-proBNP, and this contributed to patients experiencing delays in being referred for echocardiography and specialist assessment.

While there has been a recent push for GPs to have access to these tests, the report calls for the planned access to NT-proBNP in primary care to be accelerated and applied consistently across Ireland, in order to ensure potential cases of heart failure are identified at the earliest opportunity. 

 “A delayed diagnosis of heart failure has a significant impact on people’s lives and in many cases, causes avoidable health deterioration and mental distress. Heart failure merits the earliest possible diagnosis and treatment and a prolonged delay in diagnosis worsens outlook.

“It is therefore crucial that we continue to drive forward the solutions being introduced by the HSE, including ensuring that GPs have access to the right testing to improve diagnosis and management,” commented consultant cardiologist and clinical lead of the HSE’s National Heart Programme, Prof Ken McDonald.

Meanwhile, according to consultant cardiologist and medical director of the Irish Heart Foundation, Dr Angie Brown, these findings “confirm the negative impact that a diagnosis of heart failure can have on a person’s life”.

“It highlights the need to increase the awareness of the signs and symptoms of heart failure, particularly in women, and demonstrates that we must do more to facilitate a prompt diagnosis and help patients live as well as possible with their condition.

“We need policymakers to understand that service improvements focusing on the health and wellbeing of people living with heart failure can be highly cost effective, particularly against the backdrop of unacceptably high readmission rates amongst those affected,” she said.

She insisted that community-based services “should be an integral part of a heart failure pathway that extends beyond hospital care to meet patient needs at every stage of their journey after diagnosis”.

“The National Cardiac Services Review promises to go some way to addressing these issues, but we need an overarching and fully funded National Cardiovascular Policy and Strategy to ensure optimal treatment and care of people across the full spectrum of heart conditions,” Dr Brown added.

The full report can be viewed here.