Abstract
Objective: To discuss and review the importance of the cardiologist in the early recognition and approach of heart failure as terminal heart disease. Bibliographic review: Cardiovascular diseases are the number one cause of global death, with heart failure being the prototype of advanced heart disease. According to the World Health Organization, a group of cardiovascular diseases was included as the first demand for palliative care in the world, and heart failure represents a challenge in the prognostic evaluation, since many patients die suddenly, even in initial functional classes. Many of these patients are evaluated at a late stage of their illness, and the vast majority are not approached by their assistant cardiologist. Final considerations: Technical knowledge of the disease, combined with all early work with the patient and family, can provide optimized treatment and adequate symptom control at all times of the disease, which can reduce the number of early deaths and increase in expectation of life.