Impaired quality of life - Causes, assessment and management

Abstract

Sometimes considered outside of the scope of standard medical care, quality of life is -indirectly the most important goal of most patient-provider encounters. Improving physical function, reducing symptom burden, improving energy levels and endurance, managing pain, helping patients return to work, decreasing depression and anxiety, and increasing independence are among the many dimensions of quality of life enhanced from care received in cardiology and primary care settings. Poor quality of life is a frequent concern among patients with chest pain and normal coronary arteries or no obstructive coronary artery disease (CAD), with evidence that this population may endure greater quality of life impairment relative even to those with chest pain and obstructive CAD. In light of the bidirectional relationships between pain, functional status, mental health, and quality of life among these patients, providers may feel underequipped to address these enmeshed treatment goals. Therefore, providing physicians with a practical guide to understanding, measuring, and treatment quality of life factors among patients with chest pain and no obstructive CAD is an objective with potential utility and clinical significance. This chapter presents an illustrated roadmap to assessing and maximizing quality of life outcomes among patients with chest pain and normal coronary arteries, with particular emphasis on methods that are suited to the time-limited medical context and consistent with recommended care guidelines for patients with CAD.