Cardiac Rhythm Disorders in Older Adults, An Issue of Clinics in Geriatric Medicine - E-Book

Elsevier Health Sciences
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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.
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About the author

Professor, Department of Medicine

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Additional Information

Publisher
Elsevier Health Sciences
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Published on
Nov 14, 2012
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Pages
240
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ISBN
9781455747566
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Language
English
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Genres
Medical / Geriatrics
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Content Protection
This content is DRM protected.
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Heart failure is effectively a disease of older people. Eighty percent of patients are over 65 years old, and the majority of these are over 75. This figure is likely to increase significantly in the next two decades. The prognosis is worse than that of most cancers and heart failure is the commonest reason for hospital admission in the over 65s.

The problems associated with treating heart failure in older patients are more diverse and complex than in those who are younger. The diagnosis in older patients is easily overlooked and as they were excluded from most heart failure treatment trials there has been a reluctance to treat them optimally (fewer than 20% are prescribed conventional medicines). They have multiple co-morbidities which are poorly managed, they are repeatedly hospitalised, and suffer social isolation.

These important age-related treatment and management problems have been largely ignored and this book aims to redress the balance. It provides a concise, comprehensive account of the epidemiology, pathogenesis, diagnosis, treatment, management and end-of-life care of elderly patients with heart failure, based on published studies.

A Practical Guide to Heart Failure in Older People is essential reading for geriatricians, cardiologists, general hospital physicians, family practitioners and specialist nurses.

• Specifically addresses the particular needs of the elderly, a largely ignored group who constitute the majority of patients with heart failure

• Presents a concise yet comprehensive account of the evidence relating to the diagnosis, treatment and management of heart failure in this population

• Improves awareness of the various roles within the management team

As improvements in living conditions and advances in modern medicine lead to increased life expectancy and the number of older adults world-wide continues to grow, so the number of older individuals with cardiac and cerebrovascular disease is rising. Over eighty per cent of all cardiovascular disease-related deaths now occur in patients aged sixty five or older. The high prevalence of co-morbidities, frailty and cognitive decline amongst older patients requires that a holistic approach to the management of cardiovascular disease is required.

Written and edited by leading experts in the field, ‘Cardiovascular diseases and health in the older patient’ provides scholarly evidence and data which explain why treating an older patient with cardiovascular disease is often different from treating a young or middle-aged patient with the same disease. The chapters have been updated and expanded from the cardiovascular section of the renowned ‘Pathy’s Principles and Practice of Geriatric Medicine’, edited by Alan J. Sinclair, John E. Morley and Bruno Vellas. The revised chapters contain updated evidence and references to recent clinical practice guidelines in Europe and North America, this book provides complete, authoritative information on this major cause of death, poor health and disability in old age.

Covering the epidemiology, pathophysiology and management of cardiovascular disease in the older patient, the book is an excellent reference at all clinical and pre-clinical levels and will appeal particularly to geriatricians, cardiologists, and GPs, as well as cardiac specialist nurses and practice nurses.

With a Foreword by Stuart M. Cobbe.

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.
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