When Do You Bring Up Palliative Care with Patients with Adult Congenital Heart Disease?

For people with adult congenital heart disease (ACHD), some cardiologists didn’t think that patients would make it to adulthood. Fortunately, they have, and with that comes another challenge. It’s a discussion that even the most seasoned physicians might struggle with—when is it time to talk end-of-life care?

Ami Bhatt, MD, director of the Adult Congenital Heart Disease Program at Massachusetts General Hospital (MGH) explained both sides of the debate at the 66^th Scientific Session of the American College of Cardiology (ACC 2017) in Washington, District of Columbia.

Bhatt revealed that she is for talking to patients about palliative care and challenges they could face in the very beginning. “I don’t think we can hide the idea that somebody may not make it all the way to 80, that somebody may never be eligible for a transplant,” she said. “I don’t think we can hide that from the patient or their family. I think we have to engage them with it and we have to learn how to do it in a way that empowers them and doesn’t scare them.

However, Bhatt understands why some doctors don’t agree with her. If it is the first time that a patient with the diagnosis reaches an age, not even physicians necessarily know what is going to happen. The topic is negative, and nearly 60% of patients with ACHD already battle anxiety and depression.

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