El paciente con insuficiencia cardiaca terminal: dificultad en la identificación y en la toma de decisiones

ABSTRACT La insuficiencia cardiaca (IC) es una enfermedad cardiovascular con una pravalencia, incidencia y mortalidad en continuo aumento. Las pautas actuales óptimas de tratamiento consiguen sólo retardar su evolución pero no detener su progresión. La IC es una enfermedad con una alta mortalidad, incluso ya en momentos cercanos al debut. Aproximadamente al 40% de las muertes por IC serán debidos a progresión de la enfermedad a fase terminal, no obstante al curso evolutivo da la IC es difícil da predecir, por lo que identificar a los pacientes que están en fase terminal de la enfermedad en muchas ocasiones no se consigue.
Frecuentemente no existe la sensación de padecer una enfermedad terminal ni en el paciente ni en la familia, ni muchas veces tampoco en el personal sanitario, que no reconoce la proximidad da la muerte, con lo que al paciente acaba falleciendo con tratamiento activo para la IC y que muchas veces será fácil.
Las guías da las diversas sociedades médicas sobre el manejo da la IC daban incluir en sus capítulos información sobra los pacientes con IC terminal e intentar definir unos criterios pronósticos de la IC terminal.
Es necesario realizar un esfuerzo por parte de todos los profesionales de la salud para mejorar la identificación y manejo de los pacientes con IC terminal.

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Available from: Francesc Formiga, Aug 29, 2015
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