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Optimizing management in end-stage HF 

Optimizing management in end-stage HF
Chapter:
Optimizing management in end-stage HF
Author(s):

Miriam Johnson

, Karen Hogg

, James Beattie

, and Max Watson

DOI:
10.1093/med/9780199299300.003.0042
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date: 18 August 2019

The care of people with heart failure has been transformed over the past 10 -15 years. Guidelines for pharmacological and device management have been developed and service frameworks have improved services and outlook for patients.

In end stage disease, heart failure management is challenging as individuals may not be able to tolerate standard recommended medications. Thus, although the guidelines are helpful, they need to be applied to each patient and reviewed regularly. In addition, as the patient deteriorates, they may find their tablet burden excessive, and rationalising treatment with symptom relief as the focus rather than long term risk reduction is required. This chapter provides a framework within which clinicians can consider the net patient benefit for management in end stage disease.

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