Integrated heart failure service (hospital) useful links

Helping your heart work more efficiently

Resources for patients

This section contains links to relevant external websites, which we hope you will find useful. This does not mean we endorse or accept responsibility for the sites or the information found on them.

  • British Heart Foundation – charity supporting research, education, awareness about cardiovascular disease, including heart failure. Your heart failure nurse or GP should provide you with the British Heart Failure booklet, you can also order them online.
  • The Pumping Marvellous Foundation – a patient led Heart Failure charity providing help and support for people managing heart failure, as well as their carers and families.
  • Southwark and Lambeth (SAIL) Safe and Independent Living – provides a quick way to access a wide range of local services to support Southwark and Lambeth residents who are over 50 in maintaining their independence, safety and well-being.

Patient education films

In collaboration with our integrated heart failure service, The Sound Doctor has created 40 short films giving you practical advice and tips on how to manage your condition. You can watch some of the films here.

  • Heart failure introduction – video transcript

    Narrator: Welcome to the Sound Doctor. This collection of 40 films will help you understand what heart failure is, they'll explain your symptoms and they'll help you get the most out of life.

    GP: Essentially you're going to spend perhaps 10-15 minutes with the doctor, perhaps every three months. Most of the time, you're going to be looking after your condition yourself and therefore, part of the treatment in my view, is giving you enough information, facts, where to go for help if you're in trouble. I think the education and providing information for patients is as important as the drug treatment in terms of managing it.

    Narrator: Practical advice from consultants, nurses, and other professionals, and tips from people like you who live with heart failure.

    Patient: Heart failure is not the end of life. It is something that you can integrate into your life, and still live with heart failure.

    Narrator: The Sound Doctor. Easy-to-follow, easy to use. The information you need when you want it.

 

  • What is heart failure? – video transcript

    Dr Gerry Carr-White, consultant cardiologist: Heart failure is a syndrome, so it gives you particular symptoms. You get breathless, you get tired, you get swollen ankles. And it's due to the fact that the heart just can't pump enough blood round the body, either at rest or when it's doing things, so that's what gives you heart failure.

    Professor Theresa McDonagh, consultant cardiologist: It's very common, overall it depends onthe age of the patients that we're looking at, but overall its prevalence in the UK is anywhere between one to two percent of the population. Now at the end of the day all heart failure is due to the heart failing as a pump but it can really fail in two ways. One is where the left ventricle, which is the main pumping chamber of the heart, does not pump properly and its actual force of contraction of pumping is reduced and that's called left ventricular systolic dysfunction. And that accounts for about 70% of all heart failure in this part of the world. The other part, the other type of heart failure is where the heart does not relax properly, it's usually stiff or hypertrophied as a result of years of high blood pressure when the heart does not relax properly it does not fill properly if it does not fill properly it does not empty properly and that accounts for about 30% of the heart failure that we see.

    Dr Gerry Carr-White: So you have heart failure with a weak heart, that's where you have a reduced ejection fraction, that's called heart failure with reduced ejection fraction. So a normal heart pumps about the 50 or 60 percent of its blood in one beat. With this condition it will be pumping out less than 40% of its blood in one beat so the heart will be bigger and weaker. And then an equal number of people have something called heart failure with preserved ejection fraction. That's where the heart still can't pump enough blood round but it's because the heart stiff rather than its big and weak, so I think that's quite important because the treatments for those two conditions are very different actually. Most of heart failure, most of the time you're talking about a problem with the left ventricle. Now sometimes you can get weakness in the right ventricle, the right pumping chamber, that pumps the blood to the lungs and you often see that in people sometimes where they have bad lung disease and the pressures in the artery to the lungs get raised, the right side of the heart then struggles with that, so you can have a condition where the right side is weak due to lung problems, clots on the lungs, occasionally again due to inherited heart problems.

    Julia Decourcey, heart failure nurse consultant: And it's very important to understand all of these different types once you have your diagnosis because the treatment slightly different but the symptoms are not but the important thing is that once that echo scan tells a doctor what's wrong with you can start on a good treatment plan.

    Dr Mike Knapton, GP and associate medical director,  British Heart Foundation: The progression of heart failure is quite unpredictable however it is usually the case that there will be a slow but steady progression in the disease and then as that happens you might on top of that have episodes where you have acute heart failure that will admit you to hospital.

    Caroline Senior, clinical lead, cardiac services: Everyone is very different and no two cases are the same but we do know that generally over time the condition does get worse, but that can be a long, long period of time over many year

    Dr Joe Mills, consultant cardiologist: Obviously when you first present with heart failure the quicker you're diagnosed, the sooner you're put on the appropriate therapies and see a specialist usually, then that is going to impact probably on the trajectory of your condition.

    Dr Gerry Carr-White: So a lot of patients with heart failure live for a long, long time, their symptoms improve with a medical therapy we give them and so it's a very variable disease and it's a very treatable disease, so I think I would say for a lot of people with heart failure actually the outlook is good these days.

 

  • I have a heart condition – how can I help myself? – video transcript

    Sister Nicola Cotton, heart failure nurse specialist: If you are given a diagnosis of a heart failure, follow the advice given to you by a health professional. Taking your medication, getting as much exercise you possibly can, getting out and about as much as you possibly can, socialising, sticking to that healthy diet, stopping smoking. All of those things enable you to fulfil a more enjoyable life.

    Caroline Senior, clinical lead, cardiac service: It really helps if people understand the condition, understand the symptoms that it can cause, when to seek help, how to look after yourself the best you can. With the best will in the world, the healthcare professionals aren't seeing you every day, so you're the most important person in your condition. So the more you know about it, the more educated you are, the more you can manage your condition yourself.

    Dr Gerry Carr-White, consultant cardiologist: Simple things like trying to do as much exercise as you feel capable of, healthy diet, making sure you're pretty good with your medicines.

    Dr Joe Mills, consultant cardiologist: So if you take drugs such as ACE inhibitors and beta blockers, particularly those classes of drugs and some of the more new drugs, then we know that you're doing everything that you can to maximise your chances of your symptoms remaining stable and living as long as possible outside of a hospital admission.

    Hannah Simmons, heart failure nurse specialist: It's important that patients know why they're taking their medications, what the side effects of these medications are, but also they need to know how important they are to keep taking them and that they are lifelong drugs.

    Alan White, heart failure patient: I can't stress to you strongly enough, if you want to stay alive, if you want to stay as best you can treating your condition, follow the advice they give you, follow the rule of the number of tablets you take.

    Charlotte Farron, heart failure clinical nurse specialist: So flu jabs and pneumonia vaccines are important, just because your risk of complications with heart failure is obviously increased and you won't fight those infections as well as some of us. So flu jab is once a year and the pneumonia vaccine is once a lifetime.

    Dr Joe Mills: The strongest predictor of improved survival is probably exercise and I don't mean go to the gym and do an hour on the treadmill, I mean, just not being sedentary. So whatever your norm is, if you can increase what you are or were doing, to something beyond that, then that's the biggest impact you can have.

    Caroline Senior: So even if you don't feel like it, if you can remain as active as you can be, whatever that is, even if it's just walking around the house regularly, that's really important and really helpful to keep you mobile and keep you going.

    Hannah Simmons: You might initially go home feeling that you don't want to contemplate exercise and activity, but that is so important in strengthening your heart muscle, and gradually you will feel the more activity you do, the better you will do, and the more energy you will have.

    Dr Mike Knapton, GP and associate medical director, British Heart Foundation: And of course exercise is much more fun if you do it with others, and so we've found that group-based exercise, whether it be in the gym, or doing a bit of rambling or whatever, is a very effective way of gradually increasing your fitness, gradually increasing your exercise tolerance, and returning to a normal quality of life.

    Hannah Simmons: Activity doesn't have to take the form of running, and jogging, and walking, it could be through gardening, through doing some household chores, it could be through cleaning the windows, anything that might get you a little bit warm and breathless.

    Charlotte Farron: There's one lady that literally just gets up and walks around her living room every time Coronation Street break is on, that's what she does, and she feels better for it.

    Clare Pearson, heart failure cardiac rehabilitation nurse specialist: Things like hoovering, depending on how big your house is, can be quite energetic, even washing up can be quite taxing for certain people, but it is doing some kind of physical activity. Things like walking the dog. Lots of people don't even consider that when they're walking the dog, they're doing exercise, they think they're just exercising the dog, which is not the case. Making your bed can be quite energetic, playing with grandchildren, anything like that really, anything that's getting the heart pumping a bit more, getting you a bit hot, a bit sweaty and a bit breathless, means you're doing some form of exercise.

    Dr Mike Knapton: It's very important to stress that whilst exercise can make you breathless, exercising can also make you better, and what you'll be doing is training up the body, in the same way as an athlete trains up their body to increase their exercise tolerance, you can do that too. So graded exercise, sometimes under the supervision of a cardiac rehabilitation specialist, will go a long way to restoring your normal exercise tolerance. The other thing I would say is manage your cardiovascular risk factors, so eat a sensible diet, if you're overweight try and lose a bit of weight, and the message there is don't set unrealistic targets, half a stone is better than nothing, so small steps can make big differences. And thirdly, and most importantly, don't smoke and if you do, stop.

    Charlotte Farron: We don't recommend it for anyone, let alone anyone with a heart condition. There are smoking cessation groups and NHS groups, and the GP can obviously help you with the stopping smoking, if you want to.

    Caroline Senior: Certainly with alcohol, there's no reason why you can't drink alcohol, but it's just to try and spread anything out across the week, have two or three days alcohol-free a week, which is the same advice as for the general population.

    Clare Pearson: As long as you haven't been told that alcohol has caused your heart failure, then we do say that you can have it within moderation. The guideline for moderation is no more than 14 units a week for men and women.

    Niall Monaghan, heart failure patient: If you sit on the sofa every day and just watch TV and drink cups of tea, then it's going to get worse. A lot of it, I firmly believe, is what you do. The hospitals can only do so much. You've got to have the right attitude and do a lot for yourself.

    Dr Joe Mills: The most important thing is that our responsibility within the healthcare professional world, is to allow the patient, the person, to manage their condition, to understand it, to manage it for themselves, and actually that is probably our number one priority, and we know that if we do effectively, patients do the best that they can possibly do, if they are allowed to manage the condition themselves.

 

To access the full library of films please email info@thesounddoctor.org, and tell us the name of your GP practice, hospital or healthcare professional.

You will be sent a link to click on – just create a username and password of your choice.

All films are produced by The Sound Doctor in partnership with Guy's and St Thomas' NHS Foundation Trust and King's College Hospital NHS Foundation Trust, supported by Guy's and St Thomas' Charity.

 

 

Contacts

Email: gst-tr.cardiology
@nhs.net