1. Heart Failure GP teaching session 5 Dec 2016
Dr Binoy Skaria, Consultant Cardiologist

2. Learning objectives What is heart failure? Causes ? Diagnosis?
When to refer to secondary care?
Types of heart failure
Medical therapy
Device therapy
Palliation and device deactivation

3. What is heart failure ?
Clinical syndrome……that can result from any cardiac disorder….impaired ability of the ventricles to fill with or eject blood

4. Causes of heart failure
Ischemic heart disease Hypertension Valvular disease Viral myocarditis Alcohol Arrhythmias Hereditary Peripartum Rare

5. Diagnosis Clinical symptoms & signs ECG BNP / NT pro BNP
Referral to Heart failure clinic
Echo +/- other investigations

6. Medical therapy for heart failure
Diuretics
ACE inhibitors
Beta blockers
MRA
Sacubitiril Valsartan ( Entresto)
Hydrallazine + ISDN
Ivabradine
Digoxin

7. Device therapy Pacemakers ( Single, Dual & biventricular)
ICDs ( Single, Dual & biventricular )

8. Palliative Care, Device Deactivation

9. References NICE guidelines ESC / ACC guidelines Arrhythmia Alliance
British Heart Foundation

10. Contacts Jacqui.abbass @heartofengland.nhs.uk
( tel : ; fax : )
Heart failure Nurses ( via switchboard)
Oncall cardiology consultant at Solihull
Oncall cardiology registrar at BHH / GHH