The advanced heart failure disease trajectory is characterized by frequent exacerbations and disease remissions, which makes it difficult to prognosticate and to counsel patients considering more aggressive and invasive therapies. We explain how early palliative care intervention can help patients with advanced heart failure to understand disease course and maximize symptom control while continuing to pursue potentially beneficial disease-directed treatment. The management of pain and dyspnea in heart failure patients is discussed, and the similarities and differences between palliative care and hospice are explored. The reader will gain an understanding of the benefits of collaboration between palliative care providers and heart failure specialists such that health-related quality of life (HRQL) is maximized.
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Notes
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Here, we will briefly review the most common symptoms affecting heart failure patients, and refer the reader to the Primer of Palliative Care [10] for more information about these and other symptoms not discussed in this chapter.
References
Bruera E, Kuehn Net al et al. et al. (1991). The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. Journal of Palliative Care 7:6–9.
Coelho R, Ramos S et al et al. (2005). Heart failure and health related quality of life. Clin Pract Epidemol Ment Health 1:19.
Covinsky KE, Fuller JDet al et al. (2000). Communication and decision-making in seriously ill patients: findings of the SUPPORT project. The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments. J Am Geriatr Soc 48:S187–93.
Formiga F, Chivite C et al et al. (2004). End-of-life preferences in elderly patients admitted for heart failure. QJM 97:803–8.
Gibbs JS, McCoy AS et al et al. (2002). Living with and dying from heart failure: the role of palliative care. Heart 88 Suppl 2:ii36–9.
Guyatt GH et al. (1993). Measurement of health-related quality of life in heart failure. JACC 22(4); 185A–191A.
Hauptman PJ, Havranek EP et al. (2005). Integrating Palliative Care into Heart Failure Care. Arch Intern Med 165: 374–8.
Murray SA, Kendall M et al et al. (2005). Illness trajectories and palliative care. BMJ 330:1007–11.
Noyes K, Corona E et al et al. (2007). Health-related quality of life consequences of implantable cardioverter defibrillators: results from MADIT II. Med Care 45:377–85.
Quill T et al et al. (2007). Primer of Palliative Care, 4th ed. American Academy of Hospice and Palliative Medicine, Illinois.
Tanvetyanon T, Leighton JC et al. (2003). Life-sustaining treatments in patients who died of chronic congestive heart failure compared with metastatic cancer. Crit Care Med 31:60–4.
Ward C et al. (2002). The need for palliative care in the management of heart failure. Heart 87:294–8.
Wilson JF et al. (2007). In the Clinic. Heart failure. Ann Intern Med 147:ITC12-1–ITC12-16.
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Olden, A., Quill, T. (2009). Palliative Care and CHF Chapter: Aaron Olden and Timothy Quill. In: Bisognano, J.D., Earley, M.B., Baker, M.L. (eds) Manual of Heart Failure Management. Springer, London. https://doi.org/10.1007/978-1-84882-185-9_11
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DOI: https://doi.org/10.1007/978-1-84882-185-9_11
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