Heart failure and palliative care: a team approach. Miriam Johnson, Richard Lehman, editors. Oxford: Radcliffe Publishing, 2006 (x + 150 pp). ISBN 978 1 85775 643 2.

At first glance, this appeared to be another of the “palliative care for another subspecialty” works that have been appearing over the past few years. The amount of new and truly specialty-specific material in these can be limited, and one can only suppose that they are sometimes driven as much by publisher catalogue agendas as by real need. This is not the case with this short and well written book from the United Kingdom.

The editors are a palliative care physician and a general practitioner who have developed an interest in this subpopulation of patients, for whom palliative and supportive care needs have hitherto tended to be largely ignored. They are modest about their aims, and write clearly with what appears to be comprehensive referencing to the small but growing literature on caring for patients who have end-stage heart failure.

The syndrome of advanced heart failure is explained, with very readable accounts of epidemiology, pathophysiology and treatment. There is much reference to the work of one of the contributors, Scott Murray, and his coworkers in primary care at the University of Edinburgh, who have published on comparative needs of patients with heart failure and lung cancer. They highlight the fact that decision making and prognostication are, in general, harder in heart failure, which tends to run a more protracted and unpredictable course than many cancers. Murray has proposed a simple but radical alternative to attempts at precise prognosis as a guide to care planning, by asking: “Would I be surprised if my patient were to die within the next 12 months?” If the answer is “no”, then it is time to start thinking about the deployment of supportive and palliative care.1

The work is certainly UK-centric, however, for Australian readers this is still a good summary of the issues and the literature, together with some useful experience of setting up services in selected UK centres. The heart content would be of no interest to a cardiologist, just as most of the palliative care content would not be news to specialists in that discipline, but each discipline can learn about the other, and generalists will probably find some benefit in both.