Advanced Symptom Management for Heart Failure: When GDMT Isn't the Answer

Patients with advanced heart failure experience high burdens of dyspnea, pain, psychological distress, and existential suffering that persist despite optimal guideline-directed medical and device therapy. These symptoms drive hospitalizations, impair quality of life, strain caregivers, and complicate decision-making, yet they remain inconsistently addressed in routine heart failure care.

This session provides a practical, evidence-based framework for advanced symptom management in advanced heart failure, integrating cardiology and palliative care perspectives. Emphasis will be placed on safe prescribing, communication strategies, and real-world implementation across inpatient, outpatient, LVAD, and transplant settings.

Learning Objectives

• Summarize the complex pathophysiology of dyspnea and pain in advanced heart failure and best practices for effective management.
• Discuss the impact of mood disorders in heart failure and compare evidence-based pharmacologic and behavioral therapies.
• Describe the major sources of patient and caregiver distress and learn useful tools for difficult conversations.