{"id":"5bdabedbde92","type":"article","url":"https://hartvaat.nl/2026/03/25/palliatieve-zorg-in-de-cardiologie-een-state-of-the-art-overzicht/","title":"Palliatieve zorg in de cardiologie: een state-of-the-art overzicht","title_en":"","category":"algemeen","category_label":"Algemeen","professions":["cardioloog","huisarts","internist"],"tags":["acuut-hartfalen","delirium-cardiologie","ouderen","slaapapneu"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehag219","source_url":"https://doi.org/10.1093/eurheartj/ehag219","authors":["Endrit Cekaj","Frederik Sand","David H V Vogel","Peter M Spieth","Benedikt Schrage","Aitor Uribarri","Frederic De Roeck","Jordi Riera","Federico Pappalardo","Norman Mangner","Guido Tavazzi","Tom Verbelen","Christian Jung","Andreas Schäfer","Dirk Westermann","Sebastian Zimmer","Malte Kelm","Stephan Baldus","Christian Hagl","Martin Neukirchen","Farhad Bakhtiary","Georg Nickenig","Steffen T Simon","Holger Thiele","Claudia Bausewein","Lukas Radbruch","Alexandra Philipsen","Enzo Lüsebrink"],"significance":7,"published":"2026-03-25","source_date":"2026-03-25","image":"","kennis":["https://hartvaat.nl/kennis/ritmestoornissen/reanimatie-besluitvorming/","https://hartvaat.nl/kennis/cardiometabool/obstructief-slaapapneu-en-hart/"],"congress":"","summary_en":"Thanks to better treatment, more people live longer with advanced cardiovascular disease, often with a high symptom burden and complex decisions. This EHJ review summarises how palliative care — symptom management, communication, shared decision-making, advance care planning and psychosocial/spiritual support — improves quality of life and reduces low-value, high-intensity end-of-life care. It covers disease-specific aspects (heart failure, valvular disease, pulmonary hypertension, arrhythmias, congenital heart disease), ethical and legal issues such as device deactivation, and offers a practical algorithm for integrating palliative care into cardiology practice.","created":"2026-07-03T10:32:17Z","updated":"2026-07-03T13:31:14Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Door betere behandeling leven steeds meer mensen langer met gevorderde hart- en vaatziekte, vaak met een hoge symptoomlast en complexe keuzes. Dit EHJ-overzicht vat samen hoe palliatieve zorg — symptoombestrijding, communicatie, gedeelde besluitvorming, advance care planning en psychosociale en spirituele steun — de kwaliteit van leven verbetert en laagwaardige, intensieve zorg aan het levenseinde vermindert. Het bespreekt ziekte-specifieke aspecten (hartfalen, kleplijden, pulmonale hypertensie, ritmestoornissen, aangeboren hartafwijkingen), ethische en juridische kwesties zoals device-deactivatie, en biedt een praktisch algoritme om palliatieve zorg in de cardiologische praktijk te integreren.","abstract_original":"Cardiovascular disease remains the leading global cause of morbidity and mortality. Although advances in prevention, diagnostics, and disease-modifying therapies have prolonged survival, many individuals now live longer with high symptom burden, functional decline, and complex decisional needs. Palliative care (PC) for adults with advanced cardiovascular disease can improve quality of life, support caregivers, and align treatments with patient values and goals. Core elements include symptom management, effective communication, shared decision-making, advance care planning, and integration of psychosocial and spiritual support across the disease trajectory and different care settings. Current evidence demonstrates that early PC intervention can improve symptom control, enhance quality of life, reduce psychological distress, and decrease high-intensity yet low-value care near the end of life. Nevertheless, outside of heart failure populations, gaps in widespread PC implementation across populations supported with cardiac devices as well as across diverse cultural and health systems remain. This state-of-the-art review (i) synthesizes conceptual foundations, referral triggers, and delivery models for PC in cardiovascular medicine; (ii) reviews disease-specific considerations across heart failure, valvular disease, pulmonary hypertension, arrhythmias, and congenital heart disease; (iii) outlines ethical and legal issues including advance directives and device deactivation; (iv) provides practical guidance for symptom management and communication frameworks; and (v) proposes a pragmatic algorithm to support clinical integration of PC into cardiovascular medicine."}