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

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.