Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Jun 17;151(24):e1075-e1090.
doi: 10.1161/CIR.0000000000001334. Epub 2025 May 15.

Palliative and End-of-Life Care During Critical Cardiovascular Illness: A Scientific Statement From the American Heart Association

Erin A Bohula, Michael J Landzberg, Venu Menon, Carlos L Alviar, Gregory W Barsness, Daniela R Crousillat, Nelia Jain, Robert Page 2nd, Rachel Wells, Abdulla A Damluji; American Heart Association Acute Cardiac Care and General Cardiology Committee of the Council on Clinical Cardiology; and Council on Cardiovascular and Stroke Nursing
Review

Palliative and End-of-Life Care During Critical Cardiovascular Illness: A Scientific Statement From the American Heart Association

Erin A Bohula et al. Circulation. .

Abstract

Cardiac intensive care units are witnessing a demographic shift, characterized by patients with increasingly complex or end-stage cardiovascular disease with a greater burden of concomitant comorbid noncardiovascular disease. Despite technical advances in care that may be offered, many critically ill cardiovascular patients will nevertheless experience significant morbidity and mortality during the acute decompensation, including physical and psychological suffering. Palliative care, with its specialized focus on alleviating suffering, aligns treatments with patient and caregiver values and improves overall care planning. Integrating palliative care into cardiovascular disease management extends the therapeutic approach beyond life-sustaining measures to encompass life-enhancing goals, addressing the physical, emotional, psychosocial, and spiritual needs of critically ill patients. This American Heart Association scientific statement aims to explore the definitions and conceptual framework of palliative care and to suggest strategies to integrate palliative care principles into the management of patients with critical cardiovascular illness.

Keywords: AHA Scientific Statements; cardiovascular diseases; critical illness; decision making; palliative care; patient care planning; quality of life; symptom burden.

PubMed Disclaimer

Conflict of interest statement

The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.

Figures

Figure 1.
Figure 1.. Principles for patientcentered goal-concordant palliative care in patients with critical cardiovascular illness.
Figure 2.
Figure 2.. Common challenges and areas for palliative care interventions among patients with critical cardiovascular illness.
HF indicates heart failure; and PTSD, posttraumatic stress disorder.
Figure 3.
Figure 3.. Suggested management algorithm to integrate palliative care principles into the management of critical cardiovascular illness.
CICU indicates cardiac intensive care unit; GOC, goals of care; M&M, morbidity and mortality; PC, palliative care; and QOL, quality of life.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Godfrey S, Kirkpatrick JN, Kramer DB, Sulistio MS. Expanding the paradigm for cardiovascular palliative care. Circulation. 2023;148:1039–1052. doi: 10.1161/CIRCULATIONAHA.123.063193 - DOI - PMC - PubMed
    1. Cross SH, Warraich HJ. Changes in the place of death in the United States. N Engl J Med. 2019;381:2369–2370. doi: 10.1056/NEJMc1911892 - DOI - PubMed
    1. Kavalieratos D, Corbelli J, Zhang D, Dionne-Odom JN, Ernecoff NC, Hanmer J, Hoydich ZP, Ikejiani DZ, Klein-Fedyshin M, Zimmermann C, et al. Association between palliative care and patient and caregiver outcomes: a systematic review and meta-analysis. JAMA. 2016;316:2104–2114. doi: 10.1001/jama.2016.16840 - DOI - PMC - PubMed
    1. Jentzer JC, van Diepen S, Barsness GW, Katz JN, Wiley BM, Bennett CE, Mankad SV, Sinak LJ, Best PJ, Herrmann J, et al. Changes in comorbidities, diagnoses, therapies and outcomes in a contemporary cardiac intensive care unit population. Am Heart J. 2019;215:12–19. doi: 10.1016/j.ahj.2019.05.012 - DOI - PubMed
    1. Bohula EA, Katz JN, van Diepen S, Alviar CL, Baird-Zars VM, Park J-G, Barnett CF, Bhattal G, Barsness GW, Burke JA, et al. ; Critical Care Cardiology Trials Network. Demographics, care patterns, and outcomes of patients admitted to cardiac intensive care units: the Critical Care Cardiology Trials Network Prospective North American Multicenter Registry of Cardiac Critical Illness. JAMA Cardiol. 2019;4:928. doi: 10.1001/jamacardio.2019.2467 - DOI - PMC - PubMed

MeSH terms