Coronavirus: integrated heart failure service update
We know that this is a concerning time for lots of people. Even through the coronavirus situation, we remain committed to providing you and your family the best, and safest, care possible.
We are changing how we work in the cardiovascular team, so that we can continue providing the best care possible for current and new patients, both in and out of our hospital. These changes are designed to help keep everyone as safe as we can during this challenging time.
Please see our frequently asked questions and the links below for further details on changes we are making, and contact details for your clinical team.
To reduce the risk to our patients, whilst still ensuring they get the care they need, our team of consultants and nurses are carefully reviewing every single patient’s medical history and test results. Following these detailed reviews, they can find which patients need to be seen in person, which patients could have a 'virtual' review, and which patients could safely have their appointment postponed.
We are currently working to contact every patient regarding any changes. We understand that you may have waited some time for an appointment, and we apologise that your appointment may be changed.
After our detailed review, one of the following may happen:
- in some cases, we are changing appointments to a telephone consultation, and in certain circumstances, a video appointment. This prevents you from having to travel to the Trust
- some patients may be discharged back to their GP and we will write to you if this is the case. If you have been discharged back to your GP, it is because it is safe to do so. If your situation as changed, please let us know
- some appointments may be deferred without a future date being arranged at this stage. If we defer your appointment, this is because we believe it is safe to do so. You will remain on our waiting list and we will contact you in due course. If your symptoms have changed and you think you should be seen, please contact your team so we can give you the help and treatment you need.
Clinical help and advice
If you have symptoms that could be a medical emergency (such as a heart attack or stroke), call 999 and ask for an ambulance.
It is possible that you are seen in more than one service. If your query is specifically about your heart failure condition, you should direct that query as outlined below.
If you have not heard from us within three days of your scheduled appointment please contact us by emailing
email@example.com. If you are unable to use email or your query is urgent, please call 020 7188 9491. Our phone lines are very busy and there may be a wait for your call to be answered.
Visit the integrated heart failure service team page for a full list of our consultants. If you are under their care, then you are a patient of the heart failure team.
Contact us by email if you are an existing patient who has previously been seen in our service and need advice from the clinical team, email us on
firstname.lastname@example.org and we will try to email back as soon as we can. You are likely to receive the quickest response by using an email query.
Contact us by telephone on 020 7188 9491 if you need to urgently discuss your clinical condition and we will ask one of the clinicians to phone you back as soon as they can. If you leave a message on this number it may be sometime before we are able to respond to your query.
We are doing everything we can to support GPs and your patients during the coronavirus (COVID-19) situation. If you need advice from our clinical team, please use the current advice and guidance channels, including e-RS advice and guidance for written communication, or Consultant Connect to speak to a senior clinician immediately.
We would encourage you to contact our clinical team through advice and guidance before making a referrals. Our consultants are vetting all heart failure referrals as usual. We will be contacting urgent patients but we are not currently booking routine patients and so there may be a significant delay before seeing your patient. Please consider this before making any referral as our capacity to see new patients is very limited, and please warn patients that they may not be seen immediately.
Please use the following number to contact one of our clinical team (if using Consultant Connect this will be one number for all services):
At Guy’s and St Thomas’ we have a comprehensive service for patients with heart failure, which includes:
- rapid assessment and diagnosis of patients with suspected heart failure
- development of a comprehensive personalised management plan
- appropriate education and advice for patients and their carers
- referral to other clinics if needed, such as CRT pre-assessment clinic, cardiac rehabilitation, referral for psychological support, referral to advanced heart failure therapies, referral to palliative care
- management of other long term conditions.
We aim to make sure all patients receive evidence-based treatments in accordance with national and international guidelines.
We have excellent links with GPs and community services to help make sure patients’ needs are dealt with efficiently, with great emphasis on their concerns and wishes. For our local patients, we work in partnership with King’s College Hospital to provide a specialist community heart failure service.
- Ensure more patients are diagnosed and receive the treatment they need as soon as possible.
- Ensure patients have access to specialists and be prescribed evidence based treatment.
- Ensure all of a patients' needs are met in the most efficient and effective way.
- Keep patients at home in their communities wherever possible.
What is heart failure?
Heart failure means your heart is not pumping blood around your body as effectively as it should. It doesn’t mean that your heart has stopped working, but that your heart needs support to help it to work more efficiently.
There are around 68,000 new cases of heart failure diagnosed in the UK each year. The condition can affect people of all ages, but it is more common in older people. Approximately one million people in the UK are thought to have heart failure.
Symptoms of heart failure
Symptoms occur because your heart is not able to pump blood around the body efficiently. The main symptoms of heart failure are:
- breathlessness – this can result from a build-up of fluid that backs into the lungs
- feeling very tired – this is because your heart is not able to deliver enough blood and oxygen to the muscles in your body
- swollen feet or ankles – fluid retention is caused because your heart is not pumping efficiently and results in swollen legs, feet, and even swelling in your back or abdomen.
However, all of these symptoms can have other causes and you may be referred to our team for further assessment.
The symptoms of heart failure can develop quickly (acute heart failure), but they can also develop gradually (chronic heart failure).
Causes of heart failure
There are lots of reasons why people develop heart failure. The most common are heart attacks, high blood pressure and cardiomyopathies. A heart attack can cause long term damage to your heart as it can make your heart less efficient. High blood pressure will put extra strain on your heart and a cardiomyopathy is a disease of your heart muscle and may be inherited. Some of the causes are listed below:
- heart attack or ischaemic heart disease (IHD) – also called coronary artery disease – is the most common cause of heart failure
- diseases of the heart muscle (cardiomyopathy)
- high blood pressure
- diseases of the heart valve
- diseases of the pericardium – the tissue that surrounds the heart
- some types of abnormal heart rhythms (arrhythmias)
- excessive alcohol
- drugs or chemicals that may damage the heart muscle – for example, cocaine and some types of chemotherapy
- congenital heart disease – a heart condition that you were born with
- amyloidosis – abnormal proteins build up in your heart
- pulmonary hypertension – blood pressure in the blood vessels that supply your lungs are increased
- various non-heart conditions that can affect the function of the heart – for example, severe anaemia, thyroid disease and Paget's disease.
Sometimes the cause of heart failure is not known.
In most cases, heart failure is a lifelong condition that cannot be cured. The team will prescribe you medications to improve your symptoms, keep you as well as possible and help to improve your life expectancy. In addition, lifestyle changes, devices (such as pacemakers or ICD), or surgery may improve heart function or help your body get rid of excess water. Some patients may be referred to other clinics, such as the CRT pre-assessment clinic (to see if a pacemaker may help), cardiac rehabilitation, psychologists, palliative care (improved symptom control) or heart transplantation assessment clinics.
Lifestyle changes such as weighing yourself regularly will help to identify if you are accumulating too much fluid. Stopping smoking, reducing salt intake and keeping active will help keep your heart healthy. If your heart failure has been caused by alcohol excess, stopping alcohol is important. Maintaining a healthy weight will help your heart function.
Coping with heart failure can be very difficult and challenging. It’s normal to feel low or sad from time to time. Some people find it difficult to live with the uncertainty of having heart failure. Some patients may benefit from referral to our Three Dimensions for long term conditions team (3DLTC).
In cases where heart failure has a specific cause, a cure may be possible. For example, if your heart valves are damaged, it may be possible to replace them, which can cure heart failure.