More lives would be saved or improved if specialist teams cared for them, according to the National Institute for Health and Care

The Pumping Marvellous Foundation
The Pumping Marvellous Foundation – the UK’s heart failure charity

Excellence (NICE).

It has begun a public consultation, covering the immediate care of someone who is acutely unwell as a result of heart failure.

The Pumping Marvellous Foundation has been calling for a review of services since it’s creation. We are extremely interested in making an impact as a stakeholder by representing the voice of patients and carers in the NICE consultations as we represent the major stakeholder in the process the patient and families of those that suffer.

Life threatening

In a statement, Professor Mark Baker, director of the centre for clinical practice at NICE, says: “Acute heart failure is life-threatening so it’s important to diagnose the problem correctly so patients get the best treatment.”

Acute heart failure is the leading cause of hospital admission in people aged 65 years or more in the UK. “It is usually caused because the heart muscle has become too weak or stiff,” says Professor Baker.

As a consequence, the heart’s ability to pump enough blood around the body is impaired. In the UK, the most common cause is coronary artery disease, with many patients having had a heart attack in the past.

Heart failure can also be caused by:

  • High blood pressure
  • Heart muscle disease ( cardiomyopathy)
  • Heart valve problems
  • Alcohol or recreational drugs
  • An uncontrolled irregular heart rhythm (arrhythmia)
  • Congenital heart conditions (ones you’re born with)
  • A viral infection affecting the heart muscle

Symptoms and signs of heart failure include:

  • Breathlessness
  • Fatigue
  • Fluid retention

People with acute heart failure are usually admitted through the accident and emergency department. Those who are very sick tend to be admitted to intensive care units, high dependency units or coronary care units.

The remaining patients go into either the general medical wards or to the cardiology wards, depending on what treatment they need.

Uneven standards of care

However, NICE says this practice is not standardised across hospitals and different factors affect the decision, including the person’s age, whether they have any other illnesses and where the available beds are.

“The treatment patients with acute heart failure receive, and how successful that treatment is, differs depending on the unit they were admitted to,” says Professor Baker. “We would like to see all patients who are admitted to hospital with suspected acute heart failure seen by specialists through a dedicated service, regardless of the configuration of the hospital.”

The key recommendations being put forward for consultation are:

  • All hospitals admitting people with suspected acute heart failure should provide a specialist heart failure service, based on a cardiology ward and providing outreach services.
  • Ensure that all people being admitted to hospital with suspected acute heart failure have early and continuing input from a dedicated specialist heart failure team.
  • In people presenting with suspected acute heart failure, use a standardised diagnostic test for the diagnosis of heart failure
  • Perform echocardiography to establish the presence or absence of heart abnormalities in people who have tested positive for possible heart failure
  • Consider echocardiography within 48 hours of admission to enable early specialist management.

Final guidance is expected to be published in September 2014.

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