Symptom burden in heart failure: assessment, impact on outcomes, and management

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• 作者：Craig M. Alpert ; Michael A. Smith ; Scott L. Hummel…
• 关键词：Heart failure ; Palliative care ; Symptoms ; Quality of life ; Supportive care
• 刊名：Heart Failure Reviews
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：22
• 期：1
• 页码：25-39
• 全文大小：
• 刊物类别：Medicine
• 刊物主题：Cardiology;
• 出版者：Springer US
• ISSN：1573-7322
• 卷排序：22

文摘

Evidence-based management has improved long-term survival in patients with heart failure (HF). However, an unintended consequence of increased longevity is that patients with HF are exposed to a greater symptom burden over time. In addition to classic symptoms such as dyspnea and edema, patients with HF frequently suffer additional symptoms such as pain, depression, gastrointestinal distress, and fatigue. In addition to obvious effects on quality of life, untreated symptoms increase clinical events including emergency department visits, hospitalizations, and long-term mortality in a dose-dependent fashion. Symptom management in patients with HF consists of two key components: comprehensive symptom assessment and sufficient knowledge of available approaches to alleviate the symptoms. Successful treatment addresses not just the physical but also the emotional, social, and spiritual aspects of suffering. Despite a lack of formal experience during cardiovascular training, symptom management in HF can be learned and implemented effectively by cardiology providers. Co-management with palliative medicine specialists can add significant value across the spectrum and throughout the course of HF.