It is a matter of course that palliative care is important for the patients with terminal heart failure as well as terminal cancer. But heart failure is gradually getting worse while the patients repeatedly get hospitalized, so the timing of starting palliative care is difficult. In our hospital, last year 337 patients were hospitalized and 14 patients died for heart failure. We established heart failure palliative care team in 2016, and holded malti-disciplinary conference about terminal heart failure patients once a week. In doing so, we planed to reveal and share problems from multi-direction. This time, we experienced the patient who was 50s-years-old man with dilated cardiomyopathy was introduced palliative care. He was already treated with large amounts of inotropic agents, and rejected to receive LVAD (Left Ventricular Assist Device) due to exception. We want to report and review some problems, for example when was the best point to make ACP (advance care planning).
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