This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (20)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Topic Collections  • Congestive Heart Failure/ Cardiomyopathy  • Perspectives on Care at the Close of Life  • End-of-life Care/ Palliative Medicine  • Alert me on articles by topic

Steven Z. Pantilat, MD; Anthony E. Steimle, MD

JAMA. 2004;291:2476-2482.

Heart failure accounts for more hospitalizations among Medicare beneficiaries than any other condition. Its symptoms, including shortness of breath, fatigue, and edema, can be frightening and diminish quality of life. Although treatment advances have allowed patients to live longer with a better quality of life, heart failure remains a leading cause of death in the United States. Half of heart failure patients die within 5 years of diagnosis, and for many patients, death is sudden. Given the availability of effective treatments, the prevalence of distressing symptoms, and a persistent high risk of death that may occur suddenly, physicians must simultaneously treat the underlying condition while helping patients plan for future needs and complete advance directives. Using the case of Mr R, a 74-year-old man with heart failure, we illustrate ways that physicians can address these issues to improve the care of patients with heart failure, including symptom management and discussing advance directives, prognosis, and hospice care. By combining optimal medical management with palliative care, physicians can best care for heart failure patients and their families.

Author Affiliations: Palliative Care Service and Hospitalist Section, Department of Medicine, University of California, San Francisco (Dr Pantilat); Heart Failure Program, Kaiser Permanente Northern California, Santa Clara (Dr Steimle).

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Psychosocial Aspects of Pulmonary Hypertension: A Review
Wryobeck et al.
Psychosomatics 2007;48:467-475.
ABSTRACT | FULL TEXT  

Palliative care for frail older adults: "there are things I can't do anymore that I wish I could . . . ".
Boockvar and Meier
JAMA 2006;296:2245-2253.
ABSTRACT | FULL TEXT  

Drug Therapy Recommendations from the 2005 ACC/AHA Guidelines for Treatment of Chronic Heart Failure
Howard et al.
The Annals of Pharmacotherapy 2006;40:1607-1616.
ABSTRACT | FULL TEXT  

Ethics Guidelines for Destination Therapy
Dudzinski
Ann. Thorac. Surg. 2006;81:1185-1188.
ABSTRACT | FULL TEXT  

Palliative care in non-malignant diseases
Traue and Ross
JRSM 2005;98:503-506.
FULL TEXT  

Integrating Palliative Care Into Heart Failure Care
Hauptman and Havranek
Arch Intern Med 2005;165:374-378.
ABSTRACT | FULL TEXT  

N-Terminal Pro-B-Type Natriuretic Peptide as an Indicator of Possible Cardiovascular Disease in Severely Obese Individuals: Comparison with Patients in Different Stages of Heart Failure
Hermann-Arnhof et al.
Clin. Chem. 2005;51:138-143.
ABSTRACT | FULL TEXT  

Palliative Care for Patients With Heart Failure
Markowitz and Rabow
JAMA 2004;292:1744-1744.
FULL TEXT