The Meaningful Use of the Review of Symptoms in Heart Failure Patients

Review of symptoms (ROS) is a time-honored tradition in medicine and has proved to be a case-finding maneuver in general medicine patients. The authors sought to investigate the prevalence of noncardiovascular symptoms in heart failure clinics by assessment of the ROS. Of the collected ROS, shortness of breath (SOB) represented the most frequent recalled symptom (8.6%), whereas fatigue (5.3%) was the most common noncardiac symptom. Multivariate regression analysis revealed that New York Heart Association class could, at least in part, explain the occurrence of SOB (R2=.4; P<.05). Importantly, alarm symptoms such as hemoptysis and bloody stools were present in <1% of the cohort. ROS evaluation remains a valuable tool for diagnostics; however, symptom-focused questionnaires should be routinely considered as a time-efficient strategy in the ambulatory specialty clinic. Congest Heart Fail. 2011;17:31–37. ©2011 Wiley Periodicals, Inc.