In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Symptom management in severe ambulatory heart failure.

Session Palliation and end of life care in heart failure

Speaker Johann Bauersachs

Event : ESC Congress 2015

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure - Other
  • Session type : Symposium

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Palliation and end of life care in heart failure

The heart failure patient journey often ends with multiple CHF exacerbations, some of which may involve hospital admission. Many of these patients are also elderly, with multiple comorbidities that complicate their management. Indeed, as Johann Bauersachs (Hannover) reminded the audience, much of the evidence-based management does not take account of the challenges of managing symptoms in the elderly, frail adult with low blood pressure, hyperkalaemia and renal dysfunction. He illustrated his talk with a case study and provided his thoughts on optimal management. He also gave the audience the ‘heads-up’ on the newly designed DIGIT-HF trial which seeks to provide an answer to the use and potential benefit of digitoxin in advanced heart failure. ICDs have a place in the optimal management of heart failure but present us with challenges in knowing when and how to deactivate the device at the end-of-life.

Wilhelm Haverkamp (Berlin) reminded the audience of the legal requirements around deactivation of the ICD and the need to be aware of those relevant to the individual country of practice. He challenged the audience to consider the professional skills, particularly of communication, required to discuss deactivation of the ICD with the patient and their family.

Continuing the theme of communication, Ekaterini Lambrinou (Nicosia) challenged the audience to consider the psychosocial needs of the patient and family and to address not only the physical needs but to include the emotional and spiritual.

The session was brought to an end by Christiane Angermann (Wurzburg) who provided practical advice on how to recognise the patient who may be nearing the end-of-life. She reminded us of the important interaction between symptoms, psychological distress and quality of life and the need for timely palliative care and anticipatory care planning.

There is a continuing need to increase our understanding of how best to manage symptoms, both physical and emotional, in advanced heart failure and at the end-of-life. Along-side this we need to continue to optimise the knowledge and skills of all healthcare professionals to provide such care. This session provides some support for this and so I encourage you to review the accompanying slide sets.

Members get more

Join now
  • 1ESC Professional Members – access all resources from general ESC events 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are