Ok... I've Never Done This But Will Try And Be

ok... I've never done this but will try and be clear.... My husband, age 88, congestive heart failure, cardiomyopathy, has a pacemaker appeared to have fluid buildup 3days ago... some swelling in the feet but not as severe as many people... we have been able to control it with furosemide 20 mg. 2/day. He takes it some days and not others. He had a lot of congestion, coughing 3 days ago, took 40mg of this drug and eliminated much fluid. He took same the 2nd day, again peeing out fluid. He had drainage down his throat creating much deep coughing... night before last he took certizine 24 hr. which eliminated the drainage and allowed him to sleep. He felt hot to me at those times and yesterday had a temp of 100.6. He is also on Carvedilol 6.25 mg 2/day 12 hrs. apart which is taken faithfully. On Feb. 1 his in bed bp at 8:30 a.m. was 125/79 with 92 pulse rate. His breathing during these days had been shallow and short. He is 6'2 and has been dropping weight gradually, some of that is intentional on his part. His weight his a.m. was 140.5, last night was 142.5. Last night he slept very well, no coughing, no swelling in his feet at all...although I listened to his breathing during the night and it was more rapid than usual. This a.m. he awoke feeling very good. He was weak after yesterday but had a decent appetite at breakfast (no so much the last two days). We went to the YMCA and walked 3 laps, resting inbetween, had a hotdog for lunch, visited an elderly friend briefly and returned home around 3 pm.
He said about an hour later he developed a severe pain right side, about an inch below the 'tit' of his breast, feels like its the size of a dinner plate, continuous in any position, when moving it becomes worse. He has never experienced this event before. Coughing makes it extremely painful, more than just sitting, breath is short... shorter than its been. If he tries to breath deeply its too painful in his chest. His temperature at 6 pm was 99.4.
He was diagnosed with congestive heart failure about 3 years ago. He knows he is near the end of life and has made the necessary end of life arrangements. I guess our question is.... does this sound like end state congestive heart failure.... he does not want hospital care... doesn't want to die in the hospital.
He had a similar episode a few months ago and the cardiologist advised increased Furosemide which worked. Hence, we used the same advice on this episode but this congestion and coughing is much more severe than before.
Can this be a broken rib from coughing. Is this heart attack? When does one ask for palliative care. Thank you for your input.
Jane Herr