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Expanding the Paradigm for Cardiovascular Palliative Care

2023/09/25 by Sarah Godfrey, James N. Kirkpatrick, Daniel B. Kramer +1 · 34 citations
Medicine · Nursing · #Cardiac Structural Anomalies and Repair #Cardiac pacing and defibrillation studies #Disease #Heart Failure Treatment and Management #Heart disease #Heart failure #Intensive care medicine #Internal medicine #Medicine #Nursing #Palliative care #Population #Psychological intervention #Quality of life (healthcare)

paper · open access · doi:10.1161/circulationaha.123.063193

published in Circulation 148(13), 1039-1052 (Lippincott Williams & Wilkins)

openalex publication_date 2023/09/25 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/05

Abstract

Cardiovascular disease (CVD) is the leading cause of death worldwide. Despite medical advances, patients with CVD experience high morbidity and mortality rates, affecting their quality of life and death. Among CVD conditions, palliative care has been studied mostly in patients with heart failure, where palliative care interventions have been associated with improvements in patient-centered outcomes, including quality of life, end-of-life care, and health care use. Although palliative care is now incorporated into the American Heart Association/American College of Cardiology/Heart Failure Society of America guidelines for heart failure, the role of palliative care for non-heart failure CVD remains uncertain. Across all causes of CVD, palliative care can play an important role in all domains of CVD care from initial diagnosis to terminal care. In addition to general cardiovascular palliative care practices applicable to all areas, disease-specific palliative care needs may warrant individualized palliative care models. In this review, we discuss the role of cardiovascular palliative care for ischemic heart disease, valvular disease, arrhythmias, peripheral artery disease, and adult congenital heart disease. Although there are multiple barriers to cardiovascular palliative care, we recommend a framework for studying and developing cardiovascular palliative care models to improve patient-centered goal-concordant care for this underserved patient population.

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