Emotional Distress in Patients with Advanced Heart Failure

Chronic heart failure (CHF) is a leading cause of death, with a rising prevalence. The disease has a high symptom burden and a negative impact on patients’ quality of life. However, as a result of difficulties in prognostication in relation to CHF, palliative care services do not always become involved in the care of patients with CHF. Emotional distress is especially common in the advanced stages of disease, including CHF. The term ‘emotional distress’ encompasses psychiatric symptoms such as depression and anxiety, as well as the wider spectrum of entities such as low mood. Emotional distress is a less stigmatising term than the more psychiatric-based terms. This article provides an overview of the prevalence, pathophysiology and symptoms of emotional distress in patients in the advanced stages of CHF. It summarises evidence on the psychological needs of patients and provides recommendations regarding the assessment of emotional distress at the end of life. It is hoped that the article will increase understanding of the psychological symptom burden in patients with advanced heart failure. Conflicts of interest: none