“Doc, I was told I have heart failure. That sounds awful. Am I going to die?”

These were the first words from a new patient in my clinic on Monday morning, her voice trembling with fear. She had recently been diagnosed with heart failure (HF), and the term itself felt like a death sentence to her. I reassured her that, thanks to advances in medical and device therapy, this was far from the case. Modern treatments for HF have transformed it from a terminal diagnosis to a chronic condition that can be managed effectively. Yet, the name heart “failure” continues to evoke panic and resentment for some patients. This conversation exemplifies why it may be worth a revisit on the terminology we use for this condition.

The term heart “failure” has been a mainstay in medical nomenclature since the early 20th century, when the medical community sought a succinct way to describe the progressive inability of the heart to pump sufficient blood to meet the body's needs. This term, while descriptive in a pathophysiological sense, carries an emotional and psychological weight that extends beyond its clinical implications. For many patients, hearing that they have “failure” in any organ can be distressing, if not demoralizing. As clinicians, we must recognize the impact of our language and consider whether a different term could better serve our patients.

Language holds immense power in shaping perception. In medicine, it is our responsibility to convey diagnoses with clarity and compassion. The word “failure” inherently connotes defeat, inadequacy, and irreversibility. Patients may internalize this language, associating it with personal failure or a sense of hopelessness. This can adversely affect their feelings of hope or engagement with treatment plans.

Studies in patient psychology consistently show that positive framing can improve outcomes by fostering a sense of agency and optimism. Reframing HF is not merely an exercise in semantics; it is a meaningful step toward destigmatizing a condition that already imposes significant physical, emotional, and financial burdens on patients.

Current Proposals and Their Limitations

Efforts to address this issue are not new. Some have proposed alternatives including reframing from “failure” to “function.” Some leading alternatives to “heart failure” include “cardiac insufficiency,” “cardiac dysfunction,” and “advanced heart disease.” The American Medical Association House of Delegates considered a resolution advocating for the replacement of the term “heart failure” with “cardiac insufficiency,” suggesting that the latter may more accurately describe the condition without inducing unnecessary fear. Each term has its merits:

• Cardiac insufficiency accurately describes the heart's inability to meet physiological demands, yet the term feels technical and might still carry negative connotations.
• Cardiac dysfunction captures a broader range of conditions but remains somewhat vague and clinical.
• Advanced heart disease (AHD) offers clarity, relatability, and a precedent in terms like “end-stage renal disease.” It shifts the focus from failure to a condition requiring specialized care, which is often manageable.

Among these, AHD emerges as the most patient-friendly and adaptable option, striking a balance between clinical accuracy and emotional sensitivity. By adopting this term, we acknowledge the gravity of the condition while avoiding the demoralizing implications of “failure.” Furthermore, AHD enables the use of precise subtypes — such as congestive, low-output, left-sided versus right-sided, or electrical forms — that better guide treatment strategies. This nuanced approach not only improves communication between clinicians but also empowers patients by framing their condition as one that can be managed through targeted interventions.

Transitioning away from the name “heart failure” would require coordinated efforts among medical societies, educators, and policymakers. It would involve dialogue between all stakeholders, including patients with this diagnosis. The initial effort may be substantial, but the long-term benefits — improved patient morale, better engagement with care, and reduced stigma — are well worth the investment.

As physicians, we are tasked with not only treating disease but also fostering hope. A diagnosis of “heart failure” often lands with a finality that belies the many treatment options and avenues for improving quality of life. By adopting terminology that reflects the complexity and manageability of this condition, we can better align our language with the goals of modern medicine: to heal, to support, and to empower.

This is not a new conversation, but a catalyzed reboot based on a recent patient encounter I had. If we think through, as a community, the best named alternative to heart failure, we can have a major impact for all those involved with this disease. After all, words matter — and our patients deserve nothing less.

What's your suggestion to rename “heart failure”? Share in the comments.

Kevin S Shah is an advanced heart failure and transplant cardiology fellow at Cedars Sinai Heart Institute in Los Angeles, CA. He has no related conflicts of interest.

Illustration by April Brust