Dear Dr Douketis May 23, 2020
I am delighted to see CJGIM publish a supplement on Heart Failure, prognosis, management and treatment.
I would like to make 2 comments.
Firstly, I read from cover to cover, but could not see reference to ‘Obstructive Sleep Apnea’ as a significant cause of HFrEF.
Internists should be aware of this important condition as a factor in causation, and potential target for treatment.
Secondly, much is written about expensive drugs and complicated devices in treating advanced disease. It should be said that
young-presentations and heart-transplant-candidacy are much less common issues in the population we see the most, the frail
elderly. These individuals may benefit more from ‘slow medicine’ and a palliative care referral, when end-of-life reality trumps
unreasonable optimism.
Yours truly,
Hector M Baillie MD FRCPC
Heart Failure Clinic, Nanaimo BC
Canadian Journal of General Internal Medicine
6 Volume 15, Issue 3, 2020
Letter to the Editor
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