Vol 8, No 2 (2009)
Review articles
Published online: 2009-03-30
Heart failure as a subject for palliative care
Piotr Sobański, Sebastian Stec, Grzegorz Opolski
Advances in Palliative Medicine 2009;8(2):41-44.
Vol 8, No 2 (2009)
Review articles
Published online: 2009-03-30
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.
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.
Keywords
end-stage heart failure; palliative care
Title
Heart failure as a subject for palliative care
Journal
Advances in Palliative Medicine
Issue
Vol 8, No 2 (2009)
Pages
41-44
Published online
2009-03-30
Page views
548
Article views/downloads
901
Bibliographic record
Advances in Palliative Medicine 2009;8(2):41-44.
Keywords
end-stage heart failure
palliative care
Authors
Piotr Sobański
Sebastian Stec
Grzegorz Opolski
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