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This study investigated the symptom patterns and duration and associated predictors occurring prior to first heart failure (HF) admission. Data from the Managing Cardiac Function (MACARF) program from January to December 2007 were reviewed in relation to preadmission symptoms and contacts with health professionals. Patients (n = 242) were aged 78.7 years (SD 12 years), male (54%) and married (45%). Patients experienced up to seven symptoms (Mean 2.7, SD 1.4) for a median of 4.47 days (range 1-7) before admission, most commonly increased dyspnoea on exertion (88%), and for the shortest duration chest discomfort. Less than half (48%) contacted a health professional before hospitalization, most often a general practitioner (37%). The duration patients experienced before presenting to hospital was increased if they presented during business hours (beta = 2.68) or the evening (beta = 1.88) (and therefore less from midnight to 8:30 am), or with a change in symptom (beta = 1.4), whereas duration was reduced by chest discomfort (beta = -2.01) and older age (beta = -0.07). There is a significant time window during which patients and health professionals may detect and act on worsening HF symptoms. Newly diagnosed patients with HF need support to recognize and respond to these symptoms to avoid hospital admission.

S76Heart, Lung and Circulation CSANZ 2012 Abstracts 2012;21:S1-S142 was inversely related to alveolar fluid clearance (p ≤ 0.001). Plasma volume expansion was reduced at 24 h in chronic heart failure patients (p = 0.02). Conclusion: Chronic elevation of pulmonary microvascular pressure leads to decreased intrinsic bi-directional fluid flux at the alveolar-capillary barrier which may contribute to delayed resolution of acute pulmonary oedema once this barrier is breached. http://dx.

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