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May 1, 2002

Treatment of Congestive Heart Failure

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor

JAMA. 2002;287(17):2209-2210. doi:10.1001/jama.287.17.2209

To the Editor: In their Scientific Review article about treatment of advanced heart failure, Dr Nohria and colleagues1 do not discuss relief of dyspnea by administration of low-dose narcotics.2

The literature in hospice and palliative care has numerous citations about the usefulness of narcotics for palliation of symptoms.24 I have found that some patients have dramatic relief of their symptoms and commonly ask why previous physicians did not offer this simple treatment with its dramatic results. Patient and family education about disease management along with successful advance planning allows patients with advanced heart failure to be treated effectively at home.

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