Heart failure team members stand next to cardiology equipment at Guy's and St Thomas'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.