Abstract:
PURPOSE OF REVIEW:Despite its increasing prevalence and high mortality risk, heart failure is widely regarded as 'treatable'. Aggressive measures are employed even in its end stages. This review explores the clinical characteristics of heart failure, patterns of clinician response, and new data that may help to surmount current barriers to palliative approaches. RECENT FINDINGS:The 'treatment imperative' that has helped to reduce overall cardiovascular mortality marginalizes palliative approaches in heart failure. The possibility of dying remains unacknowledged, and communication about palliative options tends not to occur. Both the apparently benign nature of heart failure and its inherent unpredictability discourage end-of-life considerations. Recent studies, however, provide evidence that these barriers may be surmountable, and also furnish tools to help with prognosis. A true heart failure continuum including palliative care would be desirable, although structural barriers exist. SUMMARY:Therapeutic successes have encouraged clinicians to pursue heart failure treatment through the end stages of disease. These very successes, however, have made the course of advanced heart failure easier to predict. What is needed now is courage among clinicians to open early dialog about disease process, prognosis and palliative options with the growing number of patients with advanced disease.
journal_name
Curr Opin Support Palliat Carejournal_title
Current opinion in supportive and palliative careauthors
Stuart Bdoi
10.1097/SPC.0b013e3282f283b6subject
Has Abstractpub_date
2007-12-01 00:00:00pages
249-54issue
4eissn
1751-4258issn
1751-4266pii
01263393-200712000-00003journal_volume
1pub_type
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journal_title:Current opinion in supportive and palliative care
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journal_title:Current opinion in supportive and palliative care
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journal_title:Current opinion in supportive and palliative care
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journal_title:Current opinion in supportive and palliative care
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