(Circulation. 2000;102:e9021.)
© 2000 American Heart Association, Inc.
Cardiovascular News |
Cardiovascular News
When You’re 24, 34 ... 84?
The consequences of success affect patients at the ends of the age spectrum: the very young and the very old. As infants born with congenital heart problems survive to adulthood and their great-grandparents survive heart attacks or reach the age at which heart attacks begin, cardiologists must deal with the care delivered to these very different populations of people.
Economics play very different roles in the care of the 2 populations. "Where can medical care do the most good for the health of the population?" asked Dutch health economist Barend van Hout, PhD, at the 22nd Congress of the European Society of Cardiology in Amsterdam. "It is at the beginning and at the end. Whatever you can offer from the medical community, the best effects are at the beginning and the end."
The effects of the success in caring for infants with congenital heart
defects are now extending into the third and fourth decades of these
patients’ lives, said John Deanfield, MD, professor of
cardiology at Great Almonds Street Hospital in London.
In the 1960s, when heart surgery to care for such children was just
beginning, "the fate of children with heart disease was terrible.
Happily, the situation for children has been transformed by the
spectacular success of pediatric cardiology and
surgery. Eighty percent of children born with heart disease can be
expected to survive to adulthood," he said. "However, it has
created a new medical problem. There is now a population of adult
patients with heart disease who need