Abstract Background Palliative care (PC) for cardiovascular patients remains suboptimal, whereby only a small proportion of patients are referred to specialist palliative care, and often too late in the disease course. We investigated the reasons that prompted cardiologists to request an intervention from the PC team, and we describe the actions implemented by the PC in response to referrals from the cardiology department. Methods This retrospective study included all patients with cardiovascular disease who were referred to the mobile palliative care team of a large University Hospital in France between 2010 and 2020. All data were extracted from the medical hospital files. For all patients referred to PC during the study period, we recorded the original motive for requesting assistance, as cited in request sent from cardiology to PC. We also recorded the types of services provided by PC, the date of the first and last consultation of the patient with PC, and the number of PC consultations per patient. Results From a total of 142 cardiology patients for whom PC assistance was requested, 136 (95.8%) died, while 6 (4.2%) are still alive. In 42 patients (29.6%), there was a generic request for intervention without indicating any particular domain where specific assistance was needed. In other cases, a motive for referral to the PC mobile team was provided by cardiologists, with ethical dilemmas (35 patients; 24.6%), symptom management (23 patients; 16.2%), and discussion about where the patient could live (11 patients; 7.7%), as the most common motives (see Figure 1). In response to these referrals, the PC team provided assistance with ethical dilemmas in 69 patients (48.6%), symptom management in 28 patients (19.7%), discussion about where the patient could live in 15 patients (10.6%), 2 or more of these issues in 16 patients (11.3%), and other issues in 14 patients (9.8%) (e.g. reorientation to oncology or family support). The majority of patients had 1 (n=90, 63.4%) or 2 PC consultations (n=27, 19%), while 10 patients (7%) had 3, 9 patients (6.4%) had 4, and 6 (4.2%) had 5 or more PC consultations. Among those who died, the median number of days between the first and the last PC consultation was 0 (quartile 1=0, quartile 3=3). Conclusion This study shows that cardiologists do not necessarily have a specific motive in mind when referring patients to PC. Because many more patients received assistance with ethical dilemmas than was requested, this indicates that cardiologists may not be aware of the ethical issues at stake in the care of cardiology patients, or that they only refer patients to PC when they have no other solution or do not know what else to do for the patient. There is clearly a need to raise awareness among cardiologists about ethical issues and about the services that the PC team can provide.