Palliative trajectory markers for end-stage heart failure. Or "oh Toto. This doesn't look like kancerous!".

: Heart failure is a complex syndrome with a high morbidity and mortality rate. The Canadian mortality rate is between 25% and 40% annually. End-stage heart failure patients suffer from many debilitating symptoms. Palliative symptom management and funding programs can assist many of these patients. Unfortunately, designating a heart failure patient as palliative with a trajectory of six months or less is not an easy task. This is difficult to determine due to the lack of tangible trajectory markers and the roller-coaster nature of the trajectory itself. These circumstances were the impetus for a review of the current literature and a clinical experience in a cardiac clinic within a major teaching hospital in Vancouver. The objective was to determine if clear palliative trajectory markers for heart failure existed and, if so, could they be used to produce a tool to assist health care professionals to accurately determine a timeline of six months or less.