End-of-Life Care in Cardiovascular Disease

1. Front Matter

   Pages i-xvii

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2. Dying from Cardiovascular Disease: An Epidemiologic Perspective

   • Husam Abdel-Qadir, Adam Herman, Douglas S. Lee

   Pages 1-20

3. Decision Making About End of Life Care: Advance Directives, Durable Power of Attorney for Healthcare, and Talking with Patients with Heart Disease About Dying

   • Craig Tanner

   Pages 21-32

4. Palliative Care and Hospice in Patients with Advanced Cardiovascular Disease

   • Maria Dans, Kathleen Garcia

   Pages 33-49

5. End-of-Life Care in Hospitalized Patients with Cardiovascular and Cerebrovascular Disease

   • Pablo Díez-Villanueva, Manuel Martínez-Sellés

   Pages 51-69

6. End of Life Care in the Intensive Care Unit

   • Aluko A. Hope, Hannah I. Lipman

   Pages 71-90

7. Cardiac Patients at End of Life in the Emergency Department

   • Derrick Lowery, Christopher R. Carpenter

   Pages 91-105

8. Management of Hospitalized Patients with Unexpected Cardiopulmonary Arrest

   • Michael G. Dickinson, Christopher M. Meeusen, Daniel L. Maison

   Pages 107-119

9. End-of-Life Care in Skilled Nursing Facilities

   • Corrine Y. Jurgens, Diane K. Pastor

   Pages 121-136

10. End-of-Life Care in Pediatric and Congenital Heart Disease

    • Adrienne H. Kovacs, Anne I. Dipchand, Matthias Greutmann, Daniel Tobler

    Pages 137-154

11. Spiritual and Existential Issues

    • Stephanie Hooker, David B. Bekelman

    Pages 155-169

12. Management of Implanted Cardiac Rhythm Devices at End of Life

    • Rachel Lampert

    Pages 171-184

13. Models of End-of-Life Care in the Home Environment

    • Susan Enguidanos, Richard D. Brumley

    Pages 185-196

14. Care for Patients Dying with a Left Ventricular Assist Device

    • Justin M. Vader, Susan M. Joseph

    Pages 197-213

15. Assessment and Management of Cognitive Dysfunction and Frailty at End of Life

    • Jonathan Afilalo, Caroline Michel

    Pages 215-233

16. Back Matter

    Pages 235-240

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End-of-life issues in cardiology are becoming increasingly important in the management of patients in the cardiac unit, but there is frequently a lack of understanding regarding their impact on cardiology practice. The cardiac unit is increasingly becoming the location whereby a number of key clinical decisions relating to end-of-life care are being made, such as the decision to remove medications, the appropriate removal of cardiac devices, the management of do not resuscitate orders and the requirement for other cardiac procedures in light of the management of the terminally ill cardiac patients. Those working in palliative care need input from the cardiovascular team as the cardiologist is frequently still managing these patients until they are moved to the hospice. That this move into a hospice is often delayed until the very last moment, there is considerable onus on the cardiovascular management of these patients to be much broader in scope and take account of some of the more palliative medical decisions needed in this group of patients. This concise reference will detail the practical issues open to cardiovascular physicians and those medical professionals who manage patients reaching the end of their life from a cardiology perspective. It will detail the full management options open to them to ensure that their practice is in line with the requirements of the patient nearing the end of their life whether the cause be cardiovascular in origin or who need appropriate management of secondary cardiovascular symptoms. It will also include the various ethical, cultural and geographical issues that need to be considered when managing these patients.

“The chapters in this much-needed book are written as standalone articles on topics related to end-of-life care in adult and pediatric cardiac and vascular disease. … There has long been a need for a book like this, and this effort is greatly appreciated. … This is a terrific and important start to a growing base of literature about palliative care in cardiovascular disease. The book provides a nice overview and addresses current clinical issues such as mechanical circulatory support.” (Megan Laila Morrison, Doody’s Book Reviews, December, 2015)

• Portland VA Medical Center,, Patient-Centered Education and Research, Salt Lake City, UT, USA, Portland, USA

  Sarah J. Goodlin

• Washington University School of Medicine, St Louis, USA

  Michael W. Rich

Policies and ethics