148 Pericardial Decompression Syndrome - a Case Report of Transient Ventricular Failure Post-pericardiocentesis

Abstract

Background and Aim: Chronic heart failure (CHF) places a physical, psychosocial and financial burden on patients and carers. Provision of palliative care to CHF patients can support complex decision-making and significantly improve quality of life. This study describes characteristics of CHF patients at a tertiary referral hospital, including provision of palliative care, in the 12 months before death and during their terminal admission. Method: Retrospective medical review of 150 patients who died from CHF between Dec-2016 to May-2019 was performed. Data collection included patient and illness characteristics, palliative approach utilisation (e.g. symptom control, end-oflife management, goals of care (GOC)), and health service use. Results: Of 150 identified patients, 106 were eligible: 48 (45.3%) females and median age 84 (77.25-89) years. Commonest comorbidities were: ischemic heart disease (56.6%) and atrial fibrillation (57.5%). Referral to specialist palliative care (SPC) services occurred for 9 (8.5%) patients prior to, and 60 (56.6%) during the terminal admission. Inpatient SPC referrals occurred a median of 4 (1-8) days before death, mainly (96.6%) to manage active dying or physical symptoms. Palliative treatments included: opioids (97 patients, 92.4%) and benzodiazepines (81, 81.8%). Disease-directed medications on the day of death included: antiplatelets (18.9%) and statins (12.6%). Comfort/palliation GOC was documented in 9 (8.6%) patients on admission, and changed to this for 40 (37.7%) patients within 48 hours of subsequent death. Conclusion: Recognising and providing appropriate care for the active dying phase in CHF is both limited and challenging. New approaches to palliative care are required for CHF patients and their families.

Pericardial Decompression Syndrome: A Comprehensive Review of a Controversial Entity

“…Two (2.8%) cases reported new-onset right to left shunt occurring after right ventricular failure. 5 7 8 9 10 11 12 14 15 16 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74…”