Tag Archives: heart failure

Introduction Renal artery stenosis (RAS), traditionally the preserve of the nephrologist, is a condition of increasing interest to the cardiologist. Ninety per cent of RAS is caused by atherosclerosis and the risk factors for renal atherosclerosis and coronary atherosclerosis are the same. Furthermore, the presence of RAS alters the prognosis of co-existent cardiac disease, most notably cardiac failure and ischaemic heart disease, both directly1–3 and via its sequelae of renal failure and hypertension. Finally, the treatments for the disease, both medical and interventional, are familiar to the cardiologist, who can employ much of the knowl

A recent survey of primary care trusts (PCTs) in England found that only 26% currently offered or had previously offered natriuretic peptides for use in primary care.4 Clinicians and healthcare purchasers (PCTs in the UK) still harbour concerns about appropriate cut-offs, the extra cost of BNP/NT proBNP assays, which assay to use (BNP or NT proBNP/point-of-care or laboratory assay), lack of expedient referral pathways for patients with a raised BNP/NT proBNP level and absence of cost-benefit/effectiveness data from a prospective primary care study. Landmark studies such as the Hillingdon heart failure study5 confirmed the high negative predic

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Setting an example The primary care-based heart failure service in Gloucestershire is now four years old and has promising data from its 2006 audit. The audit comprises data from all patients (n=524) with left ventricular systolic dysfunction managed by the service throughout 2006. Results showed all-cause mortality in this high-risk group of only 8.2%, with half of these patients dying at home. In the group of patients who had died during 2006, almost one third had previously discussed and indicated the place they wished to be cared for during the final phase of their illness, with the vast majority opting for home. In over 70% of these case

Introduction Heart failure (HF) is common and is associated with a high morbidity and mortality. Forty per cent of patients with symptomatic left ventricular systolic dysfunction (LVSD) die within a year of diagnosis and 10% per annum thereafter, giving a five-year mortality rate of up to 70%.1 Estimates of the prevalence of symptomatic HF in the general European population range from 0.4–2%,2-4 with half of these patients suffering from LVSD and half from left ventricular diastolic dysfunction (LVDD).3,5 HF consumes nearly 2% of National Health Service (NHS) resources (a figure which will inevitably increase with the advent of relatively e

Easily accessible routine clinical data are summarised that identify patients whose claims are most likely to succeed.  Introduction Dr Christopher Ward The financial difficulties of the NHS, including those of cardiac services, are often highlighted in the medical press. However, patients’ financial problems are rarely addressed and the specific issue of helping heart failure patients to obtain their financial entitlements has never been discussed in the Journals. It is now widely accepted that patients with heart failure have similar needs for supportive and palliative care as do patients with cancer: to control physical and psychologica

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