Journal of cardiac failure
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Therapies to prolong life and improve quality of life for heart failure (HF) have expanded in both number and complexity. Clinicians, patients, and families are faced with an array of decisions about interventions with complex risks and benefits. Physicians must also discuss prognosis of HF and its inherent uncertainties. ⋯ Despite the inherent uncertainty in individual outcomes with heart failure, physicians should discuss prognosis as desired by the patient or as needed to plan care, particularly when anticipated survival is shorter than 1 year. Exploring and reflecting patient responses and attending to their emotions can decrease patient anxiety and promote shared decision-making.
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Venous thromboembolism (VTE) is a concerning problem for hospitalized heart failure (HF) patients. Current recommendations are that all hospitalized New York Heart Association Class III or IV HF patients should receive VTE prophylaxis. Our purpose was to describe the rate of use and the characteristics of patients receiving VTE prophylaxis in the Acute Decompensated Heart Failure National Registry (ADHERE). ⋯ Despite recommendations that all hospitalized New York Heart Association III and IV CHF patients receive venous thromboembolic disease prophylaxis, less than one third of eligible patients receive this guideline recommended therapy.