ABSTRACT
When the need for palliative care in heart failure became the subject of correspondence in the general medical journals 10 or more years ago,21,22 a frequently expressed anxiety was that this would ‘open the floodgates’ and overwhelm specialist palliative care services. At first sight, the epidemiology of heart failure appears to confirm this fear: a recent European survey suggests that nearly one person in three will suffer from heart failure at some stage.23 Fortunately, this has not been the experience of those palliative care services brave enough to have lowered their flood defences (see Chapter 10). As in so much else to do with heart failure, there are clearly complex factors at work.
