Related Experiment Video

Updated: Jul 21, 2025

Percutaneous Contrast Echocardiography-guided Intramyocardial Injection and Cell Delivery in a Large Preclinical Model
14:24

Percutaneous Contrast Echocardiography-guided Intramyocardial Injection and Cell Delivery in a Large Preclinical Model

Published on: January 21, 2018

11.7K

Palliative care in heart failure guidelines: A comparison of the 2021 ESC and the 2022 AHA/ACC/HFSA guidelines on

Moritz Blum1,2, Nathan E Goldstein1, Tiny Jaarsma3

  • 1Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

European Journal of Heart Failure
|July 26, 2023
PubMed

Insights

Palliative care is crucial for heart failure (HF) patients, with both major guidelines recommending early integration. However, only the AHA/ACC/HFSA guideline offers specific recommendations for its provision.

Area of Science:

  • Cardiology
  • Palliative Care
  • Health Policy

Background:

  • Heart failure (HF) management guidelines increasingly emphasize palliative care.
  • Two major guidelines, the 2021 ESC and 2022 AHA/ACC/HFSA, address palliative care for HF patients.
  • Understanding the nuances in their recommendations is vital for clinical practice.

Purpose of the Study:

  • To compare the definitions, concepts, and recommendations for palliative care in HF between the 2021 ESC and 2022 AHA/ACC/HFSA guidelines.
  • To identify areas of consensus and divergence in palliative care approaches for heart failure.

Main Methods:

  • Comparative analysis of the 2021 European Society of Cardiology (ESC) guideline and the 2022 American Heart Association (AHA)/American College of Cardiology (ACC)/Heart Failure Society of America (HFSA) guideline.
  • Focus on sections pertaining to palliative care for heart failure patients.

Main Results:

  • Both guidelines define palliative care as a multidisciplinary approach for patient and caregiver distress, advocating for early integration across all HF stages.
  • Key components include symptom management, prognosis communication, life-sustaining therapy discussions, and advance care planning.
  • The AHA/ACC/HFSA guideline provides official provision recommendations and distinguishes primary/secondary palliative care, advocating a needs-based approach.
  • The ESC guideline links palliative care more closely to advanced HF and end-of-life care, emphasizing symptom assessment.

Conclusions:

  • While consensus exists on the importance and components of palliative care in HF, significant differences in recommendation specifics and approach exist between the ESC and AHA/ACC/HFSA guidelines.
  • The AHA/ACC/HFSA guideline's explicit recommendations for palliative care provision represent a notable divergence.
  • Further research may be needed to reconcile these differing approaches for optimal patient care across diverse healthcare systems.

Keywords:
Guideline comparisonHeart failurePalliative care

More Related Videos

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction09:20

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

Published on: February 13, 2021

6.5K
A Surgical Model of Heart Failure with Preserved Ejection Fraction in Tibetan Minipigs07:09

A Surgical Model of Heart Failure with Preserved Ejection Fraction in Tibetan Minipigs

Published on: February 18, 2022

1.9K

Related Concept Videos

Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
14
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
16
Heart Failure VII: Nursing Interventions01:30

Heart Failure VII: Nursing Interventions

The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
97
Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
20
Heart Failure III: Clinical Manifestations01:26

Heart Failure III: Clinical Manifestations

Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
24
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.6K