Introduction

Terminal heart failure (HF) poses numerous difficulties to clinical practice, with ethical, moral, and legal dilemmas. Given that it is an advanced stage of incurable and progressive diseases, the few therapeutic possibilities that are available and tolerated aim to delay evolution, attempt to maintain the balance of organic functions, control symptoms, and offer comfort to patients. Generally, the clinical context is complex, involving interaction with other morbidities, low functionality, frailty, and high symptomatology.^–

There is undoubtedly a high risk of death, in addition to a risk of suffering from the conditions caused by the disease or resulting from treatments. Decision making in terminal HF is a challenge, in the continuous search for adequate therapies that offer strategies that benefit the patient, without adding more risks or damages than are already inherent to their clinical condition.^,

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