Breathlessness, thirst and anxiety in the end stages of heart failure
Heart failure is associated with a high symptom burden, which can have a negative effect on the life of the person with heart failure as well as their relatives/loved ones. One of the main symptoms of heart failure is breathlessness, which reduces the ability of the person to maintain independence and is associated with anxiety, fear and distress. When a patient in heart failure is approaching the end stages of the disease process, the potential benefits of treatment strategies need to be carefully balanced against the potential side-effects. This article discusses the case of John, who was admitted to hospital in heart failure, the signs and symptoms of which included breathlessness, reduced exercise tolerance and peripheral oedema in his legs, abdomen and groin. It concentrates on John’s primary symptoms of breathlessness, thirst and anxiety. Thirst resulted from the side-effects of diuretic therapy that had been administered in the management of John’s breathlessness. For the purpose of this article the patient’s name has been changed in order to protect patient confidentiality, privacy and dignity (Nursing and Midwifery Council (NMC), 2008).