Abstract
Five decades ago, heart disease was associated with significant early morbidity and
mortality. Many patients succumbed shortly after myocardial infarctions. If they survived,
they were at great risk for cardiac arrest. With significant improvements in medical
and device therapy, cardiac patients can now survive for multiple decades. Variable
clinical courses are observed, with some patients having long periods of relative
stability and others having frequent clinical decompensations necessitating recurrent
hospitalizations. Invariably, all patients will decline over time, reaching the terminal
phases of their lives. This phase is associated with unique care needs. With appropriate
management, patients can be guided through the dying phase with the dignity and comfort
they deserve.
Résumé
Il y a 50 ans, les maladies du cœur étaient associées à des taux élevés de morbidité
et de mortalité prématurées. De nombreux patients succombaient peu après un infarctus
du myocarde. S’ils survivaient, ils présentaient un risque élevé de subir un arrêt
cardiaque. De nos jours, grâce aux avancées considérables réalisées en matière de
traitements médicaux et de dispositifs thérapeutiques, la vie des patients atteints
d’une maladie cardiaque peut être prolongée de plusieurs décennies. L’évolution clinique
varie toutefois d’un cas à l’autre, certains patients profitant de longues périodes
de stabilité relative et d’autres subissant de fréquentes décompensations cliniques
qui nécessitent des hospitalisations à répétition. Tous les patients finissent invariablement
par voir leur état se détériorer au fil du temps jusqu’à ce qu’ils atteignent la phase
terminale de leur vie, laquelle exige des soins particuliers. Une prise en charge
appropriée permet d’aider ces patients à traverser cette étape ultime dans la dignité
et le bien-être qu’ils méritent.
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Article info
Publication history
Published online: February 27, 2020
Accepted:
February 14,
2020
Received:
December 30,
2019
Footnotes
See page 1066 for disclosure information.
Identification
Copyright
© 2020 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
