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Scientific letters
Management of severe heart failure by specialist palliative care
  1. ANDREW R THORNS,
  2. LOUISE M E GIBBS
  1. J SIMON R GIBBS
  1. St Christopher's Hospice
  2. 51-59 Lawrie Park Road
  3. Sydenham
  4. London SE26 6DZ, UK
  5. National Heart & Lung Institute
  6. Imperial College School of Science, Technology and Medicine
  7. London, UK
  1. Dr Louise Gibbs: s.gibbs{at}ic.ac.uk (Dr Louise Gibbs has no email address)

https://doi.org/10.1136/heart.85.1.93

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    A large number of patients die from heart failure. While a small proportion of deaths in severe heart failure are sudden, the majority will die from worsening heart failure or a comorbid condition. A retrospective study of patients with heart disease in the UK, and a prospective study of heart failure in the USA, showed that a high proportion of patients had uncontrolled symptoms at the end of life.1 ,2 In addition there was evidence of communication problems between health care professionals and patients and their carers, in particular, open communication about dying and patients' preferences about how and where they should be cared for.3Significant communication problems as well as unmet psychosocial needs have also been identified in a prospective study.4

    Specialist palliative care has traditionally offered a multiprofessional approach to manage such problems in patients with cancer and more recently motor neurone disease and AIDS. Its potential role in …

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