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Recognizing End-Stage Heart Failure

End-stage heart failure is a serious condition that can lead to death if left untreated. In this blog post, we will discuss the signs and symptoms of end-stage heart failure so that you can recognize it in yourself or a loved one and get treatment as soon as possible.

Early diagnosis and treatment are essential for prolonging life in someone with end-stage heart failure, although most people who are diagnosed with end-stage heart failure are expected to live less than one year.

What is End-Stage Heart Failure?

End-stage heart failure isn’t an uncommon diagnosis. It occurs when the organ’s ability to move oxygen-rich blood throughout the body dwindles until it can no longer do its job. Unfortunately, end-stage heart failure means that the organ has become so weakened that the only remaining option is to receive an artificial heart (a pump and driver mechanism to mimic the function of a real heart) or to receive a transplant.

Treatment of this condition typically involves trying to reduce symptoms and improve quality of life while waiting for treatment. This often includes interventions like medications, lifestyle modifications such as dietary changes, and in some cases, even surgery. For many people, receiving a prognosis of end-stage heart failure may seem devastating. However, with proper care, it’s possible to manage symptoms and even prolong life expectancy.

Signs of End-Stage Heart Failure

As we mentioned, end-stage heart failure is a serious medical condition in which the heart is unable to pump enough blood to meet the body’s needs. Heart failure is very serious and prompt intervention and assessment is necessary to improve quality of life when possible.

Symptoms that can signal major heart failure include:

  • Persistent fatigue
  • Swelling in the legs and ankles (edema)
  • Respiratory distress
  • Irregular heartbeat
  • Constipation
  • Frequent cough

Additional signs of severe heart failure may include:

  • Frequent urination
  • Lack of appetite
  • Changes in mental status
  • Increased difficulty completing everyday activities

Due to the danger posed by end-stage heart failure, it is essential that anyone experiencing these symptoms seek prompt medical attention from a doctor or specialist who can provide the necessary care and treatment for this life-threatening condition.

An earlier diagnosis can give the patient more time to get their final affairs in order. This process can include finalizing their advance directives (also known as living wills), saying goodbye to loved ones, and researching hospice care options. An earlier diagnosis can also help family members come to terms with the patient’s condition and make any necessary arrangements.

If someone is exhibiting signs of end-stage heart failure, their doctor will typically perform a physical to get more information about the symptoms. X-rays, electrocardiograms, echocardiograms, and stress tests are additional tools a physician uses to diagnose heart failure.

What Causes End-Stage Heart Failure

End-stage heart failure is the most advanced form of heart disease and can be caused by a wide range of conditions, including:

  • Coronary artery disease: Coronary artery disease is typically caused by the hardening of the arteries due to a buildup of plaque in the walls of the vessels, restricting blood flow. This disease often develops over a person’s lifetime, but certain changes can reduce your risk of developing it.
  • Cardiomyopathy: Cardiomyopathy is a disease of the heart muscle that is characterized by shortness of breath, fatigue, and a rapid heart rate. A range of treatments exists for the condition, depending on how severe the symptoms are.
  • Diabetes: Untreated diabetes can lead to excess fat and cholesterol buildup in blood vessels due to fluctuations in blood sugar levels which restricts their elasticity. High blood sugar can damage the nerves and blood vessels in the heart.
  • High blood pressure: High blood pressure strains the organ’s ability to pump efficiently. The heart is forced to work harder to push the same amount of blood through narrowed arteries. Eventually, the heart will even grow larger and thicker as it tries to handle the higher blood pressure. These changes make the heart less efficient at its job.
  • Viral infections: Some viral infections can cause damage to parts of the heart, resulting in end-stage heart failure.
  • Substance abuse: Drugs like alcohol can change the shape of the heart over time, inducing cardiomyopathy.

Regardless of the cause, however, all forms of end-stage heart failure result in life-threatening complications due to decreased efficacy in pumping and transporting oxygen throughout the body.

How is End-Stage Heart Failure Treated?

People who are diagnosed with end-stage heart failure may have multiple treatment options. Your doctor will work with you to help you determine the right plan for your situation. Some treatments that might be recommended include:

  • Medications: Some classes of medications your doctor may prescribe include angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers, I(f) channel blockers, and others.
  • Lifestyle changes: Your physician will likely also recommend that you make certain lifestyle changes like adopting a low-sodium diet, stopping smoking, and exercising to improve your quality of life.
  • Surgery: Surgery may be an option for some people with end-stage heart failure. You may be eligible for a heart transplant or to receive a (temporary) artificial heart. Surgery may not be recommended for some people because this invasive procedure might cause more harm than benefit in the final stages of heart failure.
  • Palliative care: Palliative care is a type of care that serves to make the patient as comfortable as possible. People who receive palliative care are often no longer seeking a cure for their symptoms. Hospice is a type of palliative care that serves people who are expected to live six months or less. Hospice helps people lessen their symptoms as a way to increase comfort in their final stages of life.

Some patients may seek therapy for support in coming to terms with their diagnosis and/or symptoms. Support groups may also be beneficial for both the patient and their friends and family.


End-stage heart failure is a condition that means a person’s heart can no longer function in a way that will support life. Medications and surgery may give a person a longer lifespan, but there is no cure for end-stage heart failure. There are options to make a person’s end-of-life more comfortable, including hospice care.


  1. “Caring for Someone With Heart Failure Towards the End of Life,” Marie Curie, https://www.mariecurie.org.uk/professionals/palliative-care-knowledge-zone/condition-specific-short-guides/heart-failure
  2. “End-Stage Heart Failure: What to Expect,” Samaritan, https://samaritannj.org/hospice-blog-and-events/hospice-palliative-care-blog/end-stage-heart-failure-what-to-expect/
  3. “Alcohol-Induced Cardiomyopathy,” Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/21994-alcoholic-cardiomyopathy#:~:text=Alcohol%2Dinduced%20cardiomyopathy%20is%20a,heart%20failure%20and%20severe%20problems.
  4. “How High Blood Pressure Can Lead to Heart Failure,” American Heart Association, https://www.heart.org/en/health-topics/high-blood-pressure/health-threats-from-high-blood-pressure/how-high-blood-pressure-can-lead-to-heart-failure#:~:text=The%20thickening%20and%2For%20stiffening,cardiac%20causes%20of%20heart%20failure.
  5. “Cardiomyopathy,” Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/cardiomyopathy/symptoms-causes/syc-20370709
  6. “Diabetes and Your Heart,” CDC, https://www.cdc.gov/diabetes/library/features/diabetes-and-heart.html#:~:text=Over%20time%2C%20high%20blood%20sugar,and%20can%20damage%20artery%20walls.
  7. “Coronary Artery Disease,” Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/symptoms-causes/syc-20350613
  8. “Medications Used to Treat Heart Failure,” American Heart Association, https://www.heart.org/en/health-topics/heart-failure/treatment-options-for-heart-failure/medications-used-to-treat-heart-failure
  9. “Heart Failure,” Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/heart-failure/diagnosis-treatment/drc-20373148#:~:text=To%20diagnose%20heart%20failure%2C%20your,coronary%20artery%20disease%20or%20diabetes.

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