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Heart Disease for Physicians

Heart Disease/CHF - For Physicians

The patient has 1 or 2 and 3:

  1. Poor response to (or patient’s choice is not to pursue) optimal treatment with diuretics and vasodilators (ACE inhibitors) or nitrates
  2. The patient has angina pectoris at rest resistant to standard nitrate therapy and is not a candidate for invasive procedures and/or has declines revascularization procedures
  3. New York Heart Association Class (NYHA) IV

    • EF>/=20% if documented
    • Symptoms of heart failure or angina syndrome will be present at rest

Supporting signs and symptoms:

  • Treatment-resistant symptomatic supraventricular or ventricular arrhythmias
  • History of cardiac arrest or resuscitation
  • History of unexplained syncope
  • Brain embolism of cardiac origin
  • Concomitant HIV disease

In the absence of one or more of the above findings, rapid decline or comorbidities may also support eligibility for hospice care.