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Canadian Journal of Cardiology

Management of the Dying Cardiac Patient in the Last Days and Hours of Life

Published:February 27, 2020DOI:https://doi.org/10.1016/j.cjca.2020.02.085

      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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