As a result of the aging Canadian population and improved heart failure management, more than 400,000 Canadians are currently living with heart failure. Despite recent advances in medical management, no cure exists and the annual mortality rate for heart failure remains as high as 40%. Research suggests that end-stage heart failure patients suffer to a degree that is equivalent to, or greater than that of terminal cancer patients. However, they do not receive the same degree of end-of-life care. This article discusses current issues related to the classification system, the lack of prognostic markers, and medical management of the end-stage heart failure patient, which act as barriers to implementing palliative care. Possible solutions to facilitate the effective and timely transition to palliative care, and achieve the goal of a peaceful death for the patient with end-stage heart failure are also discussed.
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