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Supportive Care in Heart Failure, 2011
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© Oxford University Press, 2008. All rights reserved. This chapter aims to describe the physiological basis of dyspnoea; discuss a conceptual model for the patient's perception and management of dyspnoea; outline useful pharmacological and non-pharmacological strategies; and summarize key considerations for patients, their families, and clinicians to manage this complex symptom. In addition, a variety of pathophysiological factors that may contribute to the symptom of dyspnoea in heart failure (HF) include chemoreceptor activation, mechanoreceptors, and impaired sense of effort/increased motor command. Dyspnoea is a common and troublesome symptom in HF. Moreover, the barriers to effective dyspnoea management are presented. A conceptual framework to guide treatment and management decisions is also provided. Monitoring dyspnoea is important for the clinician to be able to track the severity and intensity of symptoms to inform management strategies. In spite of the sparse evidence in relation to pharmacological strategies to inform practice, clinicians can be comforted by the fact that many of the needs identified by patients and their families relate to effective communication and coordination of care.
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