Back to Insight Magazine

Terminal heart disease: care options and quality of life

When someone is diagnosed with terminal heart disease, the focus of care often shifts from curative treatments to comfort, symptom management, and dignity. This article explores what terminal heart failure looks like, how to manage symptoms, and how patients and families can plan for care and emotional support during the final stages of the disease.
4 minutes
|
May 15 2025
|
Medical
|
Heart disease
Alessia Casali

Terminal heart disease — most often end-stage congestive heart failure — occurs when the heart is too weak or damaged to pump blood effectively. By this stage, the condition is no longer curable, and treatments focus on maintaining comfort, independence, and connection during the final phase of life.

What is terminal heart disease?

Terminal heart disease typically refers to stage D heart failure, where:

  • The heart’s pumping ability is severely impaired
  • Symptoms are present even at rest
  • The body struggles with blood and fluid circulation
  • There are frequent hospitalizations despite treatment
  • Medical therapies have been exhausted or are no longer effective

It may stem from ischemic heart disease, chronic hypertension, valvular heart disease, or cardiomyopathy.

Signs of end-stage heart failure

As heart disease progresses, the following symptoms often intensify:

  • Shortness of breath (dyspnea), even while sitting or lying down
  • Fatigue and weakness, making even simple tasks difficult
  • Swelling in the legs, feet, abdomen (edema)
  • Persistent coughing or wheezing (fluid in lungs)
  • Loss of appetite and weight loss
  • Confusion or difficulty concentrating (due to poor oxygenation)
  • Rapid or irregular heartbeat

Some patients may also experience chest pain, especially if underlying coronary disease is present.

Medical goals in the terminal stage

At this point, curative interventions like surgery, stents, or aggressive medications are typically no longer viable. Care transitions to a palliative or hospice approach, emphasizing:

  • Relief of distressing symptoms
  • Prevention of fluid overload
  • Maximizing time at home, not in hospital
  • Supporting emotional and spiritual wellbeing
  • Respecting the patient’s wishes and autonomy

Multidisciplinary care teams may include cardiologists, palliative care specialists, nurses, and social workers.

Symptom management options

Even in the terminal phase, much can be done to enhance comfort:

  • Diuretics (like furosemide) to reduce fluid retention
  • Opioids (low dose) for shortness of breath
  • ACE inhibitors or beta-blockers may be continued for stability
  • Low-sodium diets and fluid management
  • Oxygen therapy for breathlessness
  • Sleeping with head elevated to reduce nighttime symptoms
  • Psychosocial support to manage anxiety, fear, or depression

Patients may also choose to discontinue medications with burdensome side effects if they no longer contribute to quality of life.

Advance care planning

Planning ahead allows patients to maintain control and clarity over how they are treated and remembered. This may include:

  • Advance directives
  • Do-not-resuscitate (DNR) orders
  • Hospice enrollment for coordinated in-home care
  • Medical power of attorney
  • Legacy and end-of-life discussions with loved ones

Hospice care can often be started once a physician determines the prognosis is 6 months or less — although some patients live longer with good care.

Emotional and spiritual care

Facing the end of life with a failing heart is more than a physical journey. Patients may confront:

  • Grief over lost abilities
  • Fear of dying or what comes after
  • Anger or frustration
  • Desire for closure or reconnection

Counseling, spiritual support, rituals, and legacy projects (e.g., letters, recordings) can help bring peace and meaning in this time.

When nothing more can be done — or can it?

For some patients and families, the knowledge that death is near raises new questions: What if this didn’t have to be the end — forever?

While cryopreservation is not a treatment for heart disease, it offers one final option after legal death: preserving the body and brain at extremely low temperatures in the hope that future medical science might one day make revival and treatment possible.

At Tomorrow.bio, we provide:

  • 24/7 standby availability
  • Stabilization and perfusion immediately after death
  • Vitrification (to avoid ice damage)
  • Long-term storage in liquid nitrogen dewars

It’s not a promise — but for some, it’s a comforting possibility.

To explore whether this option fits your values, you can schedule a consultation.

What matters most in the final stage

When the heart begins to fail irreversibly, the most powerful medicine may no longer come from pills or machines — but from presence, love, dignity, and choice.

Every day can still hold meaning. Every goodbye can still be gentle. And every life, even in its final chapter, can still be lived with purpose.

About Tomorrow.bio

At Tomorrow.bio, we are dedicated to advancing the science of cryopreservation with the goal of giving people and pets a second chance at life. As Europe’s leading cryopreservation provider, we focus on rapid, high-quality standby, stabilization, and storage of terminal patients — preserving them until future medical technologies may allow revival and treatment.

Our mission is to make cryopreservation a reliable and accessible option for everyone. We believe that no life — human or animal — should end because current medical capabilities fall short.

📧 Contact us at: hello@tomorrow.bio
🌐 Visit our website: www.tomorrow.bio
🤝 Schedule a consultation: Book a call