We will now explain the different terms you may come across in relation to Heart failure (HF).
Disclaimer – from this point onward the module will look only at Left Ventricular Systolic Dysfunction (LVSD) : as this is the condition that the evidence-based guidelines support.
SIGN Guideline 147: Management of chronic heart failure PDF
NICE Guideline NG106: Chronic heart failure in adults: diagnosis and management
European Society of Cardiology: Acute and Chronic Heart Failure Guidelines
The difficulties in predicting heart failure trajectory is well evidenced. (Living & Dying Well, A National Action Plan for Palliative and end of life care in Scotland. Scottish Government (2008)).PDF
Untreated, heart failure has a poor prognosis but this can be improved considerably with early intervention and optimal treatment.
Quality of life in those living with heart failure is often worse than any other long-term condition and the condition carries a worse prognosis than many cancers (Rogers et al 2000; Juenger et al 2002).
Within 5 years of diagnosis, up to 50% of patients with heart failure will be dead. Mortality rates among newly diagnosed patients are 6% in the first month, 11% in the first 3 months and 14% in the first 6 months (Cowie et al 2000).
One of the associated challenges with these figures is the unpredictability of heart failure trajectory (see table). Heart Failure is less predictable than many other terminal diseases, comparable to other forms of progressive organ failure. There are often periods of “near death” and recovery and the course of heart failure and time spent progressing through the illness is variable for each patient.
Definition of heart failure: A complex clinical syndrome of symptoms and signs that suggest impairment of the heart as a pump supporting physiological circulation. “It is caused by structural or functional abnormalities of the heart.”
NICE Clinical Guideline No 106 (September 2018)
Heart failure symptoms usually develop over weeks and months as the heart becomes weaker and less able to pump the blood that your body needs. Heart failure usually results in an enlarged heart (left ventricle).
It is a serious condition which cannot usually be cured but it can be treated. It can cause severe impairment of both physical and social functioning and decreased energy levels. Overall, quality of life in people with heart failure declines markedly as the severity of the disease increases.
For more information on cardiac output and anatomy please see Module 1.
Eve Shannon, Heart Failure Nurse/Educator, NHS Greater Glasgow & Clyde
Mandi Smith, Lead HF Nurse, NHS Highland
Gemma Craigie-Sharland, HF Support Lead, CHSS
David Holcombe, Benefits Advisor, NHS Fife/CHSS
Dr Aynsley Cowie, Physiotherapist Cardiac Rehabilitation, NHS Greater Glasgow & Clyde
Dr John Sharp, Cardiac/Psychology, NHS Greater Glasgow & Clyde
Paul Forsyth, Pharmacist, NHS Greater Glasgow & Clyde
Leslie Cruikshank, GP, Clinical Lead, NHS Forth Valley
Lynda Blue, BHF Project Lead, Scotland
Sinead McKee, Cardiac Practitioner, NHS Forth Valley
Frances Adamson, HF Nurse/Educator, NHS Grampian
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This is the module test for ‘HEARTe 5. Cardiac rehabilitation’. It is strongly recommended that you work through the learning materials of the module prior to commencing this test. By going straight to the test you may miss out on valuable learning contained within the module. The answers to all the test questions are contained within the module. This information may have been provided in the ‘Additional Information’ boxes on some of the pages.
There are 10 questions and you must answer all of these correctly to obtain a certificate of completion.
You should allow approximately 10 minutes to complete the test.
Develop awareness of pathways for patients undergoing cardiac surgery within CR.
Recognise how behavioural change tools can enhance the patient’s journey through cardiac rehabilitation.
Michał is discharged and the Dr writes to his GP here and also to his medical care team in Poland.
