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Chronic Obstructive Pulmonary Disease and Heart Disease 

Chronic Obstructive Pulmonary Disease and Heart Disease
Chapter:
Chronic Obstructive Pulmonary Disease and Heart Disease
Author(s):

Niharika Ganta

and Laura P. Gelfman

DOI:
10.1093/med/9780190201708.003.0021
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date: 27 January 2020

Chronic obstructive pulmonary disease (COPD) and heart failure (HF) are chronic and life-limiting illnesses affecting millions of Americans. People living with these diseases have unique palliative care needs because they have a high symptom burden, unpredictable illness trajectories, and advanced therapies that may be available to them. This chapter outlines the distinct communication challenges that arise with these populations, offers communication strategies to use when educating these patients about their illness, and provides tools for eliciting their values and goals, especially after change in a patient’s health status. This chapter also discusses how to approach conversations regarding advanced therapies, including implantable cardioverter defibrillators, left ventricular assist devices, and mechanical ventilation. Finally, how to determine and discuss prognosis using validated tools such as Seattle Heart Failure Model and BODE Index are detailed.

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