We Care Hospice

Heart Disease

             1 and 2 must be present.  Factors from 3 will add supporting documentation.

             1. Is the patient optimally treated with diuretics and vasodilators, usually angiotensin-converting enzymes (ACE)Inhibitors?_____________(Optimally treated means that patients who are not on vasodilators have a medical reason for refusing these drugs, e.g., hypotension or renal disease.) 

             2. Does the patient have significant or recurrent congestive heart failure (CHF) at rest, and is classified as New York Heart Association (NYHA) Class IV?_________________________________(Class IV is defined as: patients with heart disease who have an inability to carry on any physical activity without discomfort.  Symptoms of heart failure or of the anginal syndrom may be present even at rest.  If any physical activity is undertaken, discomfort is increased.) 

             3. Documentation of the following factors will support eligibility for hospice care:

             __________Ejection fraction <20% (normal is 65%)

             __________Treatment resistant to symptomatic supraventricular or ventricular arrhythmias

             __________History of cardiac arrest or resuscitation

             __________History of unexplained syncope

             __________Brain embolism of cardiac origin

             __________Cocomitant HIV disease