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Reviews in Cardiovascular Medicine  2013, Vol. 14 Issue (1): 41-48     DOI: 10.3909/ricm0635
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Failing the Failing Heart: A Review of Palliative Care in Heart Failure
Ankit B. Shah1, Ryan P. Morrissey1, Afshan Baraghoush1, Parag Bharadwaj2, Anita Phan1, Michele Hamilton1, Jon Kobashigawa1, Ernst R. Schwarz1
1 Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA
2 Palliative Care Services, Cedars-Sinai Medical Center, Los Angeles, CA
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Abstract:
Heart failure (HF) is the most common reason for hospital admission for patients older than 65 years. With an aging population and improving survival in heart failure patients, the number of people living with HF continues to grow. As this population increases, the importance of treating symptoms of fatigue, dyspnea, pain, and depression that diminish the quality of life in HF patients becomes increasingly important. Palliative care has been shown to help alleviate these symptoms and improve patients’ satisfaction with the care they receive. Despite this growing body of evidence, palliative care consultation remains underutilized and is not standard practice in the management of HF. With an emphasis on communication, symptom management, and coordinated care, palliative care provides an integrated approach to support patients and families with chronic illnesses. Early communication with patients and families regarding the unpredictable nature of HF and the increased risk of sudden cardiac death enables discussions around advanced care directives, health care proxies, and deactivation of permanent pacemakers or implantable cardioverter defibrillators. Cardiologists and primary care physicians who are comfortable initiating these discussions are encouraged to do so; however, many fear destroying hope and are uncertain how to discuss end-of-life issues. Thus, in order to facilitate these discussions and establish an appropriate relationship, we recommend that patients and families be introduced to a palliative care team at the earliest appropriate time after diagnosis.
Key words:  Heart failure      Palliative care      Myocardial dysfunction      Therapy      Quality of life     
Published:  30 March 2013     

Cite this article: 

Ankit B. Shah, Ryan P. Morrissey, Afshan Baraghoush, Parag Bharadwaj, Anita Phan, Michele Hamilton, Jon Kobashigawa, Ernst R. Schwarz. Failing the Failing Heart: A Review of Palliative Care in Heart Failure. Reviews in Cardiovascular Medicine, 2013, 14(1): 41-48.

URL: 

https://rcm.imrpress.com/EN/10.3909/ricm0635     OR     https://rcm.imrpress.com/EN/Y2013/V14/I1/41

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