Transcript
Announcer:
You’re listening to Heart Matters on ReachMD. On this episode, Dr. Kevin Shah will discuss quality of life impacts associated with ATTR-CM and how we can address them. He’s an Advanced Heart Failure and Transplant Cardiologist at Long Beach Memorial Hospital, as well as an Associate Professor of Medicine at the University of California Irvine School of Medicine. Let’s hear from Dr. Shah now.
Dr. Shah:
ATTR-CM can affect quality of life in ways that can be easy to underestimate. Patients sometimes lose stamina, they can lose confidence, their mobility can decrease, and their sleep can be affected. All of these together can certainly impact a patient's mood, and you could see things like anxiety or depression follow, because sometimes patients feel like their body and how their body responds to this condition can be somewhat unpredictable.
I ask most of my patients—certainly all of my patients with ATTR-CM—“What are you no longer doing that matters to you?” And specifically, “What are you no longer doing that matters to you in the setting of this condition?” So specifically, these are things like, “How far can you walk?” and “Are you avoiding activities that are related to your symptoms?” Meaning, “Are your symptoms limiting your ability to do activities?”
I will ask about the patient's mood. I'll ask about how they feel about this condition and how it's impacting them. There are formal tools to assess mood, but I tend to just start the conversation, and I think patients are pretty revealing about how this condition is impacting them. Communication is part of treatment, not just for ATTR-CM, but for anything physicians do. Patients do better when they understand what their condition is, what the treatment options are, what the potential prognosis looks like, and then what their options are if their disease progresses.
So the practical approach is to just try to preserve function—keeping physical activity within limits, trying to reduce the risk of falls, making sure nutrition is adequately supported, medication simplification, involving caregivers and involving family members, and then also just setting realistic goals. Asking patients at each visit, "What are your goals, and what are you hoping to accomplish?" I try to focus with patients on the simple concept of, “What do we need to do so that you can keep living the life that you would like to live?” And certainly, how this disease interplays with that question is an important part of the care that we provide.
Announcer:
That was Dr. Kevin Shah sharing insights on quality of life in patients with ATTR-CM. To access this and other episodes in our series, visit Heart Matters on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!
