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In the Clinic |

Heart Failure With Preserved Ejection Fraction (Diastolic Dysfunction)

Theo Meyer, MD, DPhil; Jeffrey Shih, MD; and Gerard Aurigemma, MD
Ann Intern Med. 2013;158(1):ITC1-1. doi:10.7326/0003-4819-158-1-201301010-01001
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Heart failure (HF) is a serious health problem, with an estimated incidence of 660 000 cases per year in the United States, and a prevalence of more than 5 million. HF is the most common discharge diagnosis among patients older than 65 years and the primary cause of re-admission within 60 days. As the population ages, HF is expected to become an even greater public health problem.

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One more section needed
Posted on January 17, 2013
Mary Braun, MD
Dartmouth Hitchcock Clinic
Conflict of Interest: None Declared

In your otherwise thorough and very informative article on HFpEF, I noticed that you neglect to mention referral to palliative care. I think it would be very helpful for clinicians to know when to refer patients to palliative care and very helpful for patients to get referred to palliative care.

Palliative care can often help patients with symptoms, adjusting to changing roles as their disease progresses and, in a disease with an estimated mortality rate of 5%/year, end of life issues, including hospice, when the time comes. I encourage you to consider the whole lifespan of the disease as well as the whole range of treatments of HFpEF and to provide guidelines for referral to palliative care.

Thank you for your consideration.

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