Heart failure comorbidities at the end of life

Abstract

To review the impact of comorbidity in heart failure patients who are approaching the end of life and consider current treatment options in alleviating symptom burden. Renal failure, respiratory disease, anaemia, cognitive impairment, falls and urinary incontinence are common comorbidities in heart failure patients approaching the end of life. This review describes the impact of these comorbidities and gives practical advice to aid clinicians in their management. Limited evidence exists for how best to manage the majority of comorbidities in heart failure patients at the end of life. As a result a comprehensive assessment and a patient-centred approach should be sought. Prevention of many complications such as falls or delirium is likely to be possible with this approach and hence reduce the burden of these problems at the end of life.