Not the End of Care: Integrating Palliative Care into Cardiology—An Indian Perspective

Palliative care is a component of cardiovascular care, yet it remains underused and often introduced late. Cardiovascular diseases, particularly advanced heart failure, coronary artery disease, valvular disease, and refractory arrhythmias, are associated with symptom burden, functional decline, psychosocial distress, caregiver burden, and complex treatment decisions. Palliative care should therefore be integrated alongside disease-directed therapy, rather than reserved for end-of-life care. In India, implementation is challenged by limited workforce, inadequate training, rural–urban disparities, variable access to essential medicines, cultural and family factors, and financial burden. A practical model should strengthen primary palliative care within cardiology, establish referral pathways for complex needs, and link tertiary centers with primary care, home- and community-based services, and telemedicine. Such an approach can promote symptom relief, quality of life, shared decision-making, dignity, and goal-concordant cardiovascular care.