Heart failure occurs when the heart cannot pump enough blood to meet the body’s needs. End stage heart failure is the most severe form of heart failure.

A person with heart failure experiences weakening of the heart over time. Management and treatment options can help a person live with the symptoms that this condition causes, but heart failure is chronic, and there is no cure.

In end stage heart failure, the body can no longer compensate for the lack of blood the heart pumps. A person might find it difficult to breathe even when they are resting.

This article will discuss end stage heart failure, including common signs and symptoms. It will also explain the causes of the condition, as well as how to manage, treat, and help prevent it. Finally, it will explore the outlook of people with end stage heart failure.

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People with end stage heart failure or disease tend to experience symptoms all the time, even when resting.

A person with end stage heart failure may experience symptoms of cardiovascular disease, including:

End stage heart failure can also cause a person to experience kidney or liver conditions.

A person may also need regular hospitalization, and their condition may not respond well to treatment. This may worsen as the heart failure progresses.

Learn about the symptoms of congestive heart failure here.

Heart failure can be chronic and develop over time due to medical conditions that make the heart work harder than normal or damage it.

It may also be acute and develop with conditions that cause sudden damage to the heart, such as infection, blood clots in the lungs, or a heart attack.

Over time, minor heart disease may progress to the point where medications and other treatment options, aside from a heart transplant, are no longer feasible.

When this occurs, it means the person is experiencing the end stage of heart failure.

Heart failure tends to impact either the right side of the heart or the left. But in both cases, heart failure causes the heart to be unable to pump or fill with blood correctly.

Many conditions can cause or contribute to heart failure, such as:

The final stage of heart failure is also known as the end stage of heart failure. Doctors classify heart failure into stages A–D and classes I–IV to label them in terms of severity and symptoms.

According to an older 2007 study, someone with end stage heart failure typically has Stage D, NYHA Class IV heart failure.

If a person has Class IV heart failure, it means they:

  • are unable to do any amount of physical activity without experiencing discomfort
  • have symptoms of heart failure even when resting
  • experience increasing discomfort with any amount of physical activity

If a person has Stage D heart failure, it means they:

  • have objective (observational) evidence of severe heart disease
  • have severe functional limitations
  • experience noticeable symptoms even when resting

Learn about the stages of congestive heart failure here.

There is no cure for end stage heart failure. At this stage, people will need to make difficult decisions regarding how much treatment they would like without sacrificing their quality of life. They may also consider palliative or hospice care.

Palliative care

Palliative care aims to improve the quality of life for someone experiencing a life threatening condition.

Palliative care may involve treatments to reduce symptoms and address the psychosocial, mental, emotional, or spiritual needs of patients, their caregivers, and their loved ones. It may involve treatments to extend life.

Hospice care

Hospice care does not aim to extend someone’s life, only manage their symptoms. People can only receive hospice care if they agree to no longer take life-prolonging treatments.

Unlike palliative care, which can be given based on someone’s needs, hospice care can only help people with around 6 months or less to live.

Medical treatment

Medications for people with advanced heart failure may help them manage their symptoms, including:

  • Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: These medications reduce levels or actions of angiotensin, which is a hormone that raises blood pressure.
  • Beta-blockers: This medication reduces heart rate and “cardiac work.”
  • Mineralocorticoid receptor antagonists: This medication reduces the harmful effects of aldosterone, a hormone that influences blood pressure by controlling the levels of salt and water in the blood.
  • Sacubitril/valsartan: This medication blocks the effects of the renin-angiotensin system that controls blood pressure and blood water levels.
  • Diuretics: These medications increase urine output and remove fluid.
  • Hydralazine/isosorbide dinitrate: This medication helps relax blood vessels and reduce blood pressure.
  • Digoxin: This medication increases heart muscle contractions.

Learn more about heart failure medication here.

Some people may also undergo surgery to receive a:

  • Left ventricular assist device: This mechanical support device helps the left side of the heart pump blood.
  • Biventricular pacemaker: This device helps the sides of the heart pump blood.
  • Implantable cardioverter defibrillator: A device that assesses heart rate and delivers electrical pulses to correct abnormal heart rhythms.

They may also receive an artificial heart or a heart transplant.

The best way to help prevent heart failure is to make behavioral changes or establish habits that reduce the risk of conditions that cause or contribute to heart failure.

Tips for helping to prevent heart failure include:

There is no cure for heart disease.

The life expectancy associated with end stage heart failure will depend on how severe the condition is and how someone has responded to treatment.

The mortality rate of end stage heart failure can be as high as 75%.

According to a 2015 review, 38% of people who pass away due to heart failure die within a year after diagnosis, and 60% of people pass away within 5 years.

There are many medications and other therapies or ways to reduce the discomfort that end stage heart failure can cause.

Some 29–58% of people report having a good-to-excellent quality of life in every stage of heart failure.

People who receive a heart transplant have a 1-year survival rate of 91% and survive for a median of 12–13 years after the transplant.

The survival rates for people who receive a left ventricular assist device after 2, 3, and 4 years are 71%, 62%, and 45%, respectively.

End stage heart disease is the most severe form of heart disease. A person with this condition will need medical intervention to stay alive, often a mixture of medications, surgeries, or use of medical devices.

Symptoms associated with end stage heart disease include trouble breathing, exhaustion, weight loss, changes in skin color, swelling, and abdominal pain all or most of the time.