Top ten tips for palliative care clinicians caring for heart failure patients

Haider Javed Warraich, Joseph G. Rogers, Shannon M Dunlay, Ellen Hummel, Robert J. Mentz

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Heart failure (HF) is an increasingly prevalent condition with a very high symptom burden. To address challenges faced by palliative care clinicians, we assembled a team of experts to provide high-yield tips for the management of these patients. Prognosis is unpredictable in HF and many patients and physicians overestimate survival. Ejection fraction, notably, is not predictive of prognosis. It is important to have thorough discussions about implantable cardioverter defibrillators in terminally ill HF patients. Diuresis is the mainstay of managing volume overload and dyspnea in these patients and it is important to be aggressive and creative to achieve symptom relief. However, HF patients have a high burden of comorbidities and have many symptoms beyond dyspnea as well. Management in hospice remains challenging for these patients, with a significant risk for readmission to the hospital. Almost a quarter of HF patients discharged to hospice from the hospital die in less than three days.

Original languageEnglish (US)
Pages (from-to)1646-1650
Number of pages5
JournalJournal of Palliative Medicine
Volume21
Issue number11
DOIs
StatePublished - Nov 1 2018

    Fingerprint

Keywords

  • ACE inhibitors
  • beta-blockers
  • heart failure patients
  • implantable cardioverter defibrillators
  • palliative care
  • palliative inotropes

ASJC Scopus subject areas

  • Nursing(all)
  • Anesthesiology and Pain Medicine

Cite this