“I Need Help”—A mnemonic to aid timely referral in advanced heart failure

A common grievance of advanced heart failure services worldwide is late referral of patients for consideration of advanced heart failure therapies such as cardiac transplantation and left ventricular assist devices (LVADs). Late referral of heart failure patients increases the risks of right heart failure, renal and liver dysfunction, pulmonary hypertension and often cardiac cachexia. 1 Yancy C.W. Jessup M. Bozkurt B. et al. ACCF/AHA guidelines for the management of heart failure. Circulation. 2013; 128: e240-e327 Crossref PubMed Scopus (1647) Google Scholar These factors are associated with poorer outcomes after advanced heart failure therapies, or can result in patients being considered too unwell to undergo these treatments. 1 Yancy C.W. Jessup M. Bozkurt B. et al. ACCF/AHA guidelines for the management of heart failure. Circulation. 2013; 128: e240-e327 Crossref PubMed Scopus (1647) Google Scholar , 2 Mehra M.R. Canter C.E. Hannan M.M. et al. The 2016 International Society for Heart Lung Transplantation listing criteria for heart transplantation: a 10-year update. J Heart Lung Transplant. 2016; 35: 1-23 Abstract Full Text Full Text PDF PubMed Scopus (809) Google Scholar , 3 Kirklin J.K. Naftel D.C. Pagani F.D. et al. Seventh INTERMACS annual report: 15,000 patients and counting. J Heart Lung Transplant. 2015; 34: 1495-1504 Abstract Full Text Full Text PDF PubMed Scopus (1044) Google Scholar