Supportive Care in Heart Failure

by Beattie, James; Goodlin, Sarah

• ISBN13: 9780198570288
• ISBN10: 0198570287
• Edition: 1st
• Format: Hardcover
• Copyright: 2008-09-15
• Publisher: Oxford University Press

Summary

Despite recent advances in cardiovascular medicine, heart failure continues to present a challenge to physicians as a generally progressive syndrome with significant symptoms, a poor quality of life, and a high mortality. By applying the principles of palliative medicine to this condition, it is possible to offer a supportive care approach that synthesizes the experience of both the heart failure specialist and the palliative care physician, and offers the best possible quality of care to this group of patients. This book provides a practical, evidence-based overview of supportive care in heart failure.

Author Biography

James Beattie has had a long interest in heart failure. He was Clinical Lecturer in Cardiovascular Medicine at the University of Birmingham and was appointed Consultant Cardiologist at Heartlands Hospital in 1990. For about 15 years he has had an interest in palliative care for heart failure and for the past 3 years has been a National Clinical Lead for the NHS Heart Improvement Programme promoting the development of such services across England. He is a member of the Circulatory Forum of the National Council for Palliative Care and the Department of Health End of Life Care Strategy Group. He is also a member of the British Cardiovascular Society and holds fellowships of the European Society of Cardiology and the Royal Colleges of Physicians of Glasgow and London. Sarah Goodlin is a geriatrician and palliative care physician in Salt Lake City. Dr Goodlin developed the New Hampshire End of Life Project, a two-year project that initiated a state-wide collaborative to improve end of life care and developed outcome measures for care of persons near the end of life. In 1998 she initiated quality improvement projects for care of the frail elderly and for persons with advanced heart failure. In 2002 and 2003 Dr Goodlin directed two consensus conferences on Palliative and Supportive Care in Advanced Heart Failure, funded by the Agency for Healthcare Quality and the Robert Wood Johnson Foundation. She directs the Palliative Care-Heart Failure Education and Research Collaborative, a national working group of researchers and clinicians formed to improve quality of life and meet the needs of patients with advanced heart failure and their families. Dr Goodlin was also a member of the Board of Directors of the American Academy of Hospice and Palliative Medicine.

Table of Contents

Contributors	p. xiii
An overview of supportive care in heart failure	p. 1
Heart failure
The epidemiology of heart failure	p. 9
Heart failure: pathophysiology	p. 27
Heart failure-optimal pharmacological therapy	p. 49
Device therapy for heart failure patients	p. 75
Advanced heart failure: the role of the surgeon	p. 87
Interdisciplinary care in heart failure	p. 133
Patient symptomatic burden
Quality of life in heart failure	p. 147
Dyspnoea	p. 159
Sleep-disordered breathing in heart failure	p. 189
Fatigue and exercise intolerance	p. 207
Pain in heart failure patients	p. 225
Cardiac cachexia	p. 245
Cognitive impairment	p. 259
Depression and anxiety in patients with chronic heart failure	p. 273
Spiritual issues a heart failure	p. 299
The elderly patient with heart failure	p. 319
The course to death in heart failure	p. 341
The last few days of life	p. 365
Bereavement support for patients and families	p. 377
Prognostication and communication
Mortality risk assessment and prognostication	p. 393
Communication between clinicians and their heart failure patients and families	p. 417
Decision-making in advanced heart failure	p. 431
Ethical dilemmas in therapy withdrawal	p. 443
Challenges of cultural diversity	p. 451
Palliative care research in the face of uncertainty	p. 463
Coping with patients' deaths	p. 477
Index	p. 483
Table of Contents provided by Ingram. All Rights Reserved.