Heart Failure Care

Heart failure means that your heart is not able to pump blood around the body properly. It usually occurs because the heart has become too weak or stiff. 

Common symptoms of heart failure include fluids retention (swelling of the ankles or legs), breathlessness (especially when lying flat) and extreme tiredness

It does not mean that it is about to stop. However symptoms can be controlled for many years.

Who can help you manage your heart failure?

  • Your practice nurse will usually be your key clinician who monitors your health annually
  • Your GP can help too if your symptoms are worsening or you are not responding as well to treatment
  • You may need to be referred to a cardiologist or other specialist if symptoms continue to worsen

What can you do to help yourself?

  • We recommend all patients with heart failure should have full access to their electronic health records. This allows you to read what your doctor or nurse has advised and also to share this if you like with others including your family and also if you ever need to be seen by other health care or other professionals whom you trust eg Out of Hours, A&E or if you ever get admitted into hospital. Remember only you can have full access to your electronic health records and hence only you can share this with others if you wish to with those whom you trust. 56% of patients with heart failure could do this (correct on 27th January 2019). Here are the latest figures for now. 
  • It is important NOT to smoke and to improve your lifestyle by eating a healthy diet and exercising regularly. Contact Be Well Tameside or ask your doctor or nurse if you would like help
  • Make sure you take your medication regularly and on time. Online services can really help by ensuring you order your prescriptions on time regularly. The Evergreen Life app also allows you to set notifications on your smartphone to remind you when it is time to take your medication and you can even record when you have taken it to remind yourself in case you are unsure! 
  • Learn about Heart Failure
  • Know your numbers! You should know what your usual blood pressure, pulse and weight is.
  • Buy a blood pressure machine so that you can monitor your blood pressure and pulse at home. Clinically validated blood pressures can cost from £19.99 if you shop around. Your pharmacist may be able to help you find the right machine based on your needs
  • Learn how to check your blood pressure including
  • Monitor your weight. Get digital scales if you can so that you can accurately weigh yourself using the same scales and in the same conditions each time. A change in weight may suggest you are retaining fluids or losing too much and may give an early warning something is not right.
  • Ensure you have blood tests and your urine checked at least once a year – you can monitor your blood tests by looking at your electronic health records and checking when they were last done and whether it is well-controlled or not. (Your nurse or doctor can advise you on what the normal values should be for you. Watch this video to learn more about understanding your blood test results).
    • Kidney function (Urea, Creatinine, eGFR)
    • Lipid profile (Total cholesterol, HDL, LDL, triglycerides)
    • Diabetes status (HbA1c)
    • Liver function tests 
  • Check for anxiety and depression. Patients can often begin to feel anxious or depressed. We can all have an “off day” occasionally but if you find you are constantly feeling low or anxious then please speak to your doctor or nurse
  • Make sure you have your flu jab.
  • Make sure you are taking the right medication and are on the right dose. Most patients with heart failure should be prescribed and ACE Inhibitor as well as a Beta-Blocker:
    • an ACE Inhibitor or Angiotensin II antagonist. This should ideally start at a low dose and gradually increased to the maximum tolerated dose (without your blood pressure falling too low or getting side effects such as a persistent cough with the ACE Inhibitor). Ask your doctor or nurse if you are on the maximum tolerated dose 
    • Beta-blockers. This should ideally start at a low dose and gradually increased to the maximum tolerated dose (without your blood pressure falling too low) Ask your doctor or nurse if you are on the maximum tolerated dose 
    • Loop Diuretics otherwise known as “water tablets”
    • Mineralocorticoid / Aldosterone receptor antagonists eg spironolactone / eplerenone
    • Others eg digoxin, anticoagulant therapy or ivabradine
    • Consider if you should be on an anti-platelet drug eg aspirin or clopidogrel
    • Consider if you should be on a statin  

Pumping Marvellous

Click here to download the Heart Failure Toolkit 
Listen to Nick Hartshorne-Evans from Pumping Marvellous talk about Heart Failure and his own experience