A common word may be giving heart patients the wrong idea
Cardiologists often use the word “stable” when describing a heart failure patient who is recovering or showing signs of improvement. According to a new commentary in the Journal of Cardiac Failure, however, it may be time to retire that word for good and start choosing alternatives that are more accurate and helpful.
“In heart failure, ‘stable’ is a semantic paradox,” wrote Anuradha Lala, MD, a cardiologist with Icahn School of Medicine at Mount Sinai, and Robert J. Mentz, MD, a cardiologist with Duke University School of Medicine. “It implies a state of equilibrium when, in reality, our patients remain vulnerable—often precariously so. Data from recent registries and national databases show that even among outpatients, the risk of death or recurrent hospitalization remains strikingly high. Even in the context of contemporary clinical trials with exceptional background therapy, patients have substantial residual risk.”
Lala and Mentz, the journal’s two editors-in-chief, noted that saying a patient is in stable condition can provide comfort to clinicians and patients alike. While it signals to patients that they are on the path to recovery, it’s a sign to the care team that they can transition to other patients as necessary. All of this comfort, however, “may come at a cost.”
“For clinicians, it may foster therapeutic inertia—a subtle but pervasive hesitancy to further optimize medications, revisit volume status, or re-examine goals of care,” the two co-authors wrote. “For patients and caregivers, it can signal that vigilance is no longer necessary—that adherence, monitoring, and proactive engagement are less critical.”
Lala and Mentz suggested that clinicians skip the word altogether and try to provide more detail when describing a patient’s condition. For example, how do recent test results compare to previous testing? That is the type of information that can truly make a difference for the patient—and it is less likely to create a false sense of security.
“Let us replace ‘stable’ in our vernacular with a clearer context of observation, precision and empathy,” the authors wrote. “Let us describe, not label. Measure, not assume. Understand, not reassure. In doing so, we honor both the rigor of science and the art of heart failure care—each incomplete without the other.”
Click here to read the full editorial in the Journal of Cardiac Failure.
Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.