Palliative Care in Congestive Heart Failure

Research output: Contribution to journalReview article

248 Scopus citations

Abstract

Symptoms and compromised quality of life prevail throughout the course of heart failure (HF) and thus should be specifically addressed with palliative measures. Palliative care for HF should be integrated into comprehensive HF care, just as evidence-based HF care should be included in end-of-life care for HF patients. The neurohormonal and catabolic derangements in HF are at the base of HF symptoms. A complex set of abnormalities can be addressed with a variety of interventions, including evidence-based HF care, specific exercise, opioids, treatment of sleep-disordered breathing, and interventions to address patient and family perceptions of control over their illness. Both potential sudden cardiac death and generally shortened length of life by HF should be acknowledged and planned for. Strategies to negotiate communication about prognosis with HF patients and their families can be integrated into care. Additional evidence is needed to direct care at the end of life, including use of HF medications, and to define management of multiple sources of distress for HF patients and their families.

Original languageEnglish (US)
Pages (from-to)386-396
Number of pages11
JournalJournal of the American College of Cardiology
Volume54
Issue number5
DOIs
StatePublished - Jul 28 2009

Keywords

  • end of life
  • heart failure
  • palliative care
  • symptom management

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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