Heart failure (HF) is a common end stage in any structural or functional cardiac disease advanced enough to
impair the filling of the ventricles or blood ejection. If the degree of impairment makes the heart unable to
cope with the actual demands of pumping blood, the diagnosis of heart failure is justified. The heart first
disables the circulation during exercise and finally, in end-stage HF, even at rest. HF is a progressive process,
usually only slowed by the treatment currently available. Thus from diagnosis, the disease will accompany
patients for the rest of their lives, sometimes becoming the cause of death. A patient reaching end-stage
heart failure should be considered for one of four treatment options: mechanical circulatory support; continuous
intravenous positive inotropic therapy; a referral for cardiac transplantation; or hospice care. Before
the patient is considered to have end-stage HF, all curable factors potentially causing a deterioration in
cardiac function have to be actively explored and corrected. This paper focuses on patients for whom
methods to improve prognosis and heart function have been exhausted. The number of such patients is
increasing continuously. This is caused by the growing incidence of heart failure, improvement in the medical
care prolonging survival, and progress in decreasing the number of sudden cardiac deaths in the early stages
of the disease.
Abstract
Heart failure (HF) is a common end stage in any structural or functional cardiac disease advanced enough to
impair the filling of the ventricles or blood ejection. If the degree of impairment makes the heart unable to
cope with the actual demands of pumping blood, the diagnosis of heart failure is justified. The heart first
disables the circulation during exercise and finally, in end-stage HF, even at rest. HF is a progressive process,
usually only slowed by the treatment currently available. Thus from diagnosis, the disease will accompany
patients for the rest of their lives, sometimes becoming the cause of death. A patient reaching end-stage
heart failure should be considered for one of four treatment options: mechanical circulatory support; continuous
intravenous positive inotropic therapy; a referral for cardiac transplantation; or hospice care. Before
the patient is considered to have end-stage HF, all curable factors potentially causing a deterioration in
cardiac function have to be actively explored and corrected. This paper focuses on patients for whom
methods to improve prognosis and heart function have been exhausted. The number of such patients is
increasing continuously. This is caused by the growing incidence of heart failure, improvement in the medical
care prolonging survival, and progress in decreasing the number of sudden cardiac deaths in the early stages
of the disease.
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