End of Life Care | Specialist care | Heart failure in end-of-life care

Heart failure in end-of-life care
Session overview
Description
This session has been written by a multidisciplinary group of cardiology and palliative care specialists to help palliative care clinicians become more confident with managing patients with heart failure and knowing when to liaise with heart failure services.

This session was reviewed by Megha Agarwal, Amy Gadoud and Sarah Hanrott and last updated in May 2023.

By the end of this session you will be able to:

• apply knowledge of the disordered pathophysiology in the management of heart failure
• explain decompensation of heart failure, classes of heart failure drugs and when and which drugs to consider stopping in advanced heart failure
• describe the different types of device therapy in heart failure and what needs to be considered before the patient is approaching end of life
• discuss the management of refractory symptoms such as breathlessness
• identify why it is important to work collaboratively with other services

For those with little experience of working with patients with heart failure, before commencing this session you should have:

• completed the session End-stage cardiac disease (215-0505)

Heart failure (HF) is the most common diagnosis in patients aged 65 and over admitted to hospitals in developed countries.

Despite advances in management, the five year survival for patients diagnosed with heart failure is still worse than many cancers [1](read details regarding the reference). A diagnosis of heart failure confers significant physical and psychological burdens for patients and their carers, often over an extended period of time [2](read details regarding the reference).

However, despite international and national consensus guidelines that recommend a collaborative cardiology and palliative care approach and access to palliative services for people with advanced heart failure, these initiatives have not been implemented consistently [3](read details regarding the reference),[4](read details regarding the reference),[5](read details regarding the reference).