Tag Archives: heart failure

There are many major challenges in managing cardiorenal syndrome, its prevalence is high (in 30% of hospitalised patients with heart failure),5 it is associated with a wide range of comorbidities, its diagnostic criteria remain arbitrary, the fine balance between potential damage and therapeutic effect with the current medical treatment is hard to strike, its prognosis remains poor and its prevention has been hardly explored by the medical profession. Prevention is better than cure Prevention of cardiorenal syndrome, as in other medical conditions, would be much more fruitful than any treatment once occurred. The current prevention of cardior

Introduction Heart failure (HF) is a clinical syndrome characterised by breathlessness, leg swelling and fatigue, which is caused by a primary cardiac abnormality. HF can be categorised into HF with a reduced ejection fraction (HFrEF; ejection fraction <50%) or HF with a preserved ejection fraction (HFpEF; ejection fraction >50%).1 It was estimated in 2012, in Ireland, that 90,000 people had HF, with another 160,000 people at risk of developing the disease.2 There are also an estimated 10,000 new cases of HF every year.2 Both prevalence and incidence have likely increased since 2012 due to the ageing population and increases in comorbid

Case An 81-year-old woman presented to our cardiac centre with acute onset ischaemic sounding chest pain during week 4 of the first COVID-19 lockdown in the UK. She reported increasing anxiety since the start of isolation. The onset of chest pain was related to a package dropped off by her family and occurred within an hour of receiving it. Although welcome, this caused her a mixed extreme of emotions as it both heightened her sense of loneliness and anxiety, while at the same time caused her pleasure from family contact. Her past medical history included permanent atrial fibrillation (AF), hypertension, hypercholesterolaemia and iron deficie

Introduction Cardiorenal syndromes (CRS) are defined as a spectrum of disorders affecting the heart and kidney, in which acute or chronic dysfunction of one organ leads to acute or chronic dysfunction of the other.1,2 Management of this condition can be challenging as it portends significant morbidity due to symptom burden, as well as recurrent hospitalisations and increased mortality.1-3 In addition, as there is a relative paucity of evidence-based therapy, management strategies for CRS have been largely empirical and goal-directed towards improvement of function of one organ, frequently at the cost of the other. For instance, acute kidney i

A 72-year-old woman was referred to our cardiology service with increasing dyspnoea on exertion. Her background history was notable for haemochromatosis, type 2 diabetes mellitus, chronic kidney disease (stage 3a), treated pulmonary tuberculosis and known pericardial calcification. Echocardiography (figure 1A) demonstrated a calcified structure evident on the apical four-chamber view, which appeared to indent the right ventricle. Computed tomography (CT) of the thorax (figure 1B) demonstrated extensive and circumferential pericardial calcification with a maximal thickness of up to 20 mm in the right atrial pericardial region, 12 mm in the inf

The British Society for Heart Failure (BSH) has therefore produced a position statement designed to help easily identify and prioritise patients that should be considered for review. It will also support local teams to identify a lead clinician that they can contact for advice. BSH recommends that the following patients are considered for review: New referrals of symptomatic patients with NTproBNP >2,000pg/ml from primary care or recent A&E attendance Known HF patient with symptoms of decompensation Recently discharged patients following admission with acute heart failure Patients with advanced care plans and receiving palliative car

Dr Sze, BJCA essay prize winner Introduction According to the European Society of Cardiology Atlas project, >83 million people suffered from cardiovascular diseases in Europe in 2015.1 Heart failure (HF) is a common chronic disease in the ageing population. It is associated with poor prognosis, recurrent admissions and limited quality of life.2 Despite development of effective guideline-based treatment, the prognosis of HF patients remains poor. With the advancement of cyber technologies, digital healthcare has become more popular and may develop as a promising way to tackle challenges in HF management. The objectives of this article are:

NICE heart failure guidelines The latest National Institute for Health and Care Excellence (NICE) guidelines for management of chronic heart failure (NG 106)1 were presented by Dr Abdallah Al-Mohammed (Sheffield Teaching Hospitals). It was fascinating to hear Dr Al-Mohammed describe his work on producing the guidelines with respect to what recommendations the authors are permitted to include and how recommendations may be presented. Key changes include the removal of a history of a previous myocardial infarction from the initial assessment of a patient with suspected chronic heart failure. Other changes include the guidelines now using the te

There is no precise definition of what constitutes a HFSN, and the exact number of HFSNs and where they are located is not well understood. Therefore, one of the key recommendations of the inquiry was that Health Education England should work with the Royal College of Nursing and the Nursing and Midwifery Council to ascertain the number and location of HFSNs. Despite this recommendation, no particular body appeared to come forward to undertake this crucial piece of work. At the Pumping Marvellous Foundation’s Heart Failure Summit 2017,3 which was comprised of multi-stakeholders, the commitment was made by the charity, supported by an unres

Introduction Frailty is a distinctive health state, related to the ageing process, in which multiple body systems gradually lose their in-built reserves, and is related to poorer outcomes.1 There have been numerous tools developed to identify frailty,2-4 often these tools are complex and not suitable for identifying patients at the time of admission to hospital, requiring a comprehensive geriatric assessment to validate them. The British Geriatrics Society developed the Frailsafe5,6 checklist, which was piloted across 12 UK hospitals in 2014 as part of the Frailsafe collaborative. The tool used three screening indicators to identify patients