Communication and Decision Making in Advanced Heart Disease

Part 1: Introduction

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Decisions likely to be made as heart disease advances


As heart disease advances patients may be presented with the following options, interventions and outcomes. Learning about potential poor outcomes is essential to the decision-making process. Click on the titles below to reveal the Interventions and Outcomes.

Options


Interventions to improve function

Interventions to reduce cardiac arrest

Interventions for acute HF decompensation

Interventions to replace heart

Intervention


CABG, value surgery, PCI, CRT, pericardial stripping

ICD

IABP, VAD, ECMO, IV inotropes, dialysis, destination LVAD

Transplantation, total artificial heart

Poor outcomes


Worse cardiac function, need for ongoing circ support, stroke, can not get in lead

Inappropriate shocks, device deactivation

Unable to wean, decision to discontinue, bleeding

Graft failure, circ support, stroke, bleeding, infection

Glossary

CABG - Cardiac Artery Bypass Graft
PCI - Percutaneous Cardiology Intervention
CRT - Cardiac Resynchronization Therapy
ICD - Implantable Cardioverter Defibrillator
IABP - Intra-Aortic Balloon Pump
VAD - Ventricular Assist Devicebr
ECMO - Extracorporeal Membrane Oxygenation
LVAD - Left Ventricular Assist Device