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With an exponential growth in the number of older adults,
understanding the common disorders of the elderly patient requiring
cardiac care is becoming increasingly important. Incorporating
recent advances in the field, Tresch and Aronow's Cardiovascular
Disease in the Elderly 6th Edition has been completely revised and
updated to provide cardiologists, primary care physicians,
geriatricians and other clinicians caring for the elderly a
comprehensive and accessible overview of the epidemiology,
pathophysiology and treatment of cardiovascular disorders in older
patients.
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.
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.
With an exponential growth in the number of older adults,
understanding the common disorders of the elderly patient requiring
cardiac care is becoming increasingly important. Incorporating
recent advances in the field, Tresch and Aronow's Cardiovascular
Disease in the Elderly 6th Edition has been completely revised and
updated to provide cardiologists, primary care physicians,
geriatricians and other clinicians caring for the elderly a
comprehensive and accessible overview of the epidemiology,
pathophysiology and treatment of cardiovascular disorders in older
patients.
This issue of Clinics in Geriatric Medicine, guest edited by Drs.
Cynthia Boyd, James T. Pacala, and Michael W. Rich, is devoted to
Chronic Conditions in Older Adults with Cardiovascular Disease.
Articles in this issue include: Epidemiology of multimorbidity in
older adults with cardiovascular disease; Impact of multimorbidity
on clinical outcomes in older adults with cardiovascular disease;
Assessment of goals of care in patients with multiple chronic
conditions; Challenges in decision-making: balancing trade-offs;
Multimorbidity in older adults with heart failure; Multimorbidity
in older adults with acute coronary syndromes; Multimorbidity in
older adults with aortic stenosis; Multimorbidity in older adults
with atrial fibrillation;Anticoagulation in older adults with
multimorbidity; Approach to evaluating the multimorbid patient with
cardiovascular disease undergoing non-cardiac surgery; Integrating
care across disciplines; Assessing risks and benefits of invasive
cardiac procedures in patients with advanced multimorbidity;
Multimorbidity and end of life care in patients with cardiovascular
disease; and Future research directions for cardiovascular disease.
This issue of Clinics in Geriatric Medicine focuses on the
pharmacological, non-pharmacological, and device therapies in the
medical management of cardiac rhythm disorders in the elderly
population. It also reviews the epidemiology of arrhythmias and
conduction disorders in older adults, atrial fibrillation and
atrial flutter: stroke prevention, bradyarrhythmias and conduction
disorders, and comorbidities, quality of life, and end-of-life
issues in older patients with heart rhythm disorders.
With cardiovascular disease as the leading cause of death in the
United States, the topic of preventive cardiology deserves intense
examination. Michael Rich and George Mensah guest edit this issue,
which explores important topics, such as the burden of
cardiovascular disease, updates on hypertension, hyperlipidemia,
and diabetes, all geared towards the elderly patient. This issue of
Clinics in Geriatric Medicine also covers the effects of physical
activity on cardiovascular and non-cardiovascular outcomes, impact
of strength and resistance training on cardiovascular risk factors
and outcomes, cellular mechanisms and the effects of caloric
restriction, obesity and the obesity paradox, and the primary and
secondary prevention of cardiovascular diseases in older adults.
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