Palliative care for end-stage heart failure.

Heart failure is growing in prevalence. Despite an array of treatments targeting a complicated pathophysiology, heart failure ultimately leads to death, and thus there is a clear need to provide palliative care to persons with end-stage heart failure. Palliative care, or education and support of the patient and family and management of distressing symptoms, should be provided throughout the course of the illness. Clinicians need additional information about how to palliate symptoms in advanced heart failure. This article summarizes recent reports about prognostication and identification of patients who are likely to die soon, and the management of fatigue, dyspnea, pain, and depression in heart failure. Palliative care or supportive care of the patient and family should be incorporated into comprehensive care throughout the course of heart failure. Data about hospice care for persons with heart failure are summarized.