End-stage heart failure or terminal heart failure is characterized by fatigue, shortness of breath, progressive muscle wasting and inability to exercise despite optimal medical and surgical therapy.
The study also provides insight into existing knowledge gaps regarding appropriate monitoring of patients and selection of management options.
Very few physicians, for example, ask patients to complete quality-of-life questionnaires or objectively measure functional status, two key factors that help determine a patients status.
This failure suggests that physicians may not appropriately recognize the impact of heart failure on their patients, Hauptman says.
The study also found that doctors rarely discuss deactivating implantable cardioverter defibrillators with very sick heart failure patients and their families.
Implantable cardioverter defibrillators detect cardiac arrhythmias and correct the condition by delivering an electrical shock. For people who are at risk of sudden cardiac death, this device can be a life saver.
For patients with advanced heart disease, though, an implantable cardioverter-defibrillator can cause unnecessary discomfort and stress because it can continue to deliver shocks as the patient is dying. While the majority of physicians surveyed agreed that deactivating the device is appropriate with end-stage heart failure, very few heed this advice.
Using a random stratified survey, 1,450 physicians (600 cardiologists, 300 geriatricians and 300 internal and family medicine doctors), were polled for the study. Approximately 60 percent of physicians polled responded to the survey.
|Contact: Sara Savat|
Saint Louis University