Abstract
Heart failure follows an unpredictable disease trajectory. Several models now exist to help with prognostication, but accurate prediction remains difficult. Symptom management for pain, dyspnea, and depression is the primary goal of palliative treatment. Palliative treatments for CHF can overlap greatly with disease-modifying therapies such as in the use of diuretics and vasodilators to improve edema and exertional dyspnea. Discussing goals of care along with advance care planning should be done before a crisis. Quality of life for patients should be discussed early in the disease trajectory of heart failure. Patient and family education about the terminal nature of heart failure, hospice as a treatment option, and deactivating implanted devices is critical.
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