Dilemmas in end-stage heart failure.

Area of Science:

• Cardiology
• Public Health
• Bioethics

Background:

• Heart failure (HF) affects over 23 million worldwide, representing a major global health challenge.
• HF is a leading cause of hospitalization for older adults, straining healthcare systems.
• The clinical course of HF is unpredictable, impacting end-of-life care planning.

Purpose of the Study:

• To discuss the epidemiology of heart failure.
• To analyze the financial impact of heart failure.
• To explore the challenges in end-stage heart failure care.

Main Methods:

• Literature search conducted on PubMed (U.S. National Library of Medicine).
• Keywords used: end-stage heart failure, palliative care, ethical dilemmas.
• Review of existing data on HF epidemiology and care.

Main Results:

• Despite a prognosis worse than many cancers, awareness of HF's severity is often low among patients, caregivers, and clinicians.
• Underutilization of palliative and hospice care is common due to the unpredictable nature of HF.
• Numerous ethical dilemmas arise in end-stage HF care, involving patients, caregivers, healthcare teams, and society.

Conclusions:

• End-stage heart failure presents numerous ethical dilemmas.
• Improved awareness of HF prognosis is crucial for timely palliative care.
• Addressing these challenges requires a multi-faceted approach involving all stakeholders.