Heart Failure Service

About Heart Failure

Heart Failure is a general term that describes what happens when the heart becomes less effective at pumping blood around the body. It is a frequent cause for admission to hospital and affects about 1 million people in the UK with 68 000 new cases diagnosed each year. The most common symptoms are breathlessness, feeling fatigued and swelling around the ankles. There are a wide range of conditions that can cause heart failure.

Managing Heart Failure

Your clinician may suggest a series of tests and treatments. You may have a blood test, an ECG (electrocardiogram) to look at the heart’s electrical activity and an ECHO (echocardiogram) which is an ultrasound scan to look at the heart. Heart failure often requires long term management involving hospital as well as your GP services and specialist community heart failure teams. Some of the options we may discuss with you include:

• Lifestyle changes such as managing your fluid intake, diet and exercise
• These can help the heart work more efficiently and get rid of excess water
• Implantable devices such as pacemakers
• Surgical treatments

Self-managing your condition is very important and we aim to educate and support our patients to help achieve this. Taking your medications as prescribed along with lifestyle changes can help your heart work more effectively and improve your symptoms.

Our Team

The St George’s Heart Failure team is dedicated to excellence in specialist and evidence-based heart failure care. Our team is made up of a variety of health care professionals from various disciplines. Including highly trained cardiologists, heart failure registrars, specialist heart failure nurses and a dedicated heart failure therapy team with a specialist physiotherapist, heart failure dietician, occupational therapist and heart failure pharmacist. We work closely with our team of specialist community heart failure nurses covering Wandsworth, Sutton, Merton, Lambeth and Croydon. We have close links with the heart rhythm team for complex heart rhythm management and device implantation, which may help in heart failure such as advanced pacemakers and defibrillators. There is also ready access to the extended multidisciplinary team such as the pulmonary hypertension service, palliative care, cardiac rehabilitation, sleep clinic, respiratory and renal physicians.

Our services

Our team provides a comprehensive service in Heart Failure in both the hospital and community settings.

Acute Heart Failure Unit

Our acute Heart Failure Unit opened in 2016 with 11 beds. It is the only dedicated specialist heart failure unit in the UK. We specialise in managing the most complex and high-risk heart failure patients in the hospital. There are daily consultant led ward rounds, supported specialist heart failure nurses, physiotherapist, occupational therapist, dietician and pharmacist.

Other inpatient services

We provide a heart failure service covering the entire hospital. We have daily Consultant ward rounds reviewing inpatients with heart failure on medical and surgical wards. We are proactive in identifying all new admissions with heart failure in the hospital and have an inpatient specialist heart failure nurse covering all the cardiology and cardiothoracic wards.

Rapid access heart failure clinic

This is a one stop Consultant led heart failure clinic for all new patients with suspected heart failure. We accept referral from both the hospital and community. Patients are assessed by a consultant cardiologist and we also offer several diagnostic tests at the clinic including blood tests, echocardiograms, ECGs and chest X-rays.

Heart Failure Specialist Nurse clinics

We have 3 nurse led clinics per week for patients with heart failure. We assess the patient’s progress, adjust and monitor heart failure medications, educate patients and family members and help improve the ability to self-monitor and manage their condition.

Cardio-renal clinic

This is a joint weekly clinic run by consultant cardiologists and nephrologists for patients who have both heart and renal failure. Renal failure can make management of heart failure more complex and this clinic helps achieve the best possible outcomes for our patients.

Heart Failure Dietician clinic

Our heart failure dietician runs weekly outpatient clinics and telephone reviews for patients with heart failure, providing monitoring and education on dietary changes required in heart failure, nutritional supplements if indicated and support with self-monitoring.

Cardiac resynchronisation therapy clinics

Some of our heart failure patients benefit from implantable pacemakers called cardiac resynchronisation therapy (CRT) devices. Our CRT clinic is run by a consultant cardiologist and 2 specialist heart failure nurses trained in echocardiography. We assess the progress of patients with CRT devices and adjust the devices settings to improve outcomes.

Outpatient Heart Failure Rehabilitation.

Cardiac rehabilitation is recommended for patients with heart failure. We have developed a new service providing dedicated heart failure rehabilitation classes including “sitting” classes for patients who cannot mobilise because of their heart failure or frailty.

Entresto Clinics

This is a novel treatment available for some patients with heart failure with a drug called Sacubitril-Valsartan (Entresto). Our specialist nurse led clinic provides close monitoring and supervision when patients are started on this drug.

IV Iron Infusion Service

Intravenous Iron is now recommended for some patients with heart failure.  The Heart Failure Nurses and Pharmacist run an infusion service for appropriate patients.  This will require patients to attend our day-case unit for about 90 minutes to receive an iron infusion.  There will then be a blood test to check the effectiveness of the transfusion a few weeks later.  Your Heart Failure Nurse or Consultant will refer you to the team if appropriate.

Cardio-Metabolic Clinic

This is a joint clinic run by consultant cardiologists and endocrine specialists for patients who have both heart and other metabolic conditions that have an impact. This allows effective care and the best possible outcomes for these more complex patients.

Consultants

• Dr Lisa Anderson– Consultant Cardiologist
• Dr Nesan Shanmugam– Consultant Cardiologist
• Dr Robin Ray– Consultant Cardiologist
• Dr Fadi Jouhra – Consultant Cardiologist
• Dr Mark Peterzan – Consultant Cardiologist

Specialist Heart Failure Nurses

• Matthew Sunter – Lead Heart Failure Nurse
• Catriona Schwendtner
• Siobhan Armstrong
• Sinead Lyons
• Jolanta Stwora-Fuah
• Rebecca Coleman
• Laura Bijman – Heart Failure Pharmacist
• Lilly Mandarano – National Heart Failure Audit Nurse
• Katherine Holloway – Ward Manager, Heart Failure Unit

Therapy team

• Samantha Grozotis – Highly Specialised Physiotherapist in Heart Failure
• Rebecca Jones – Specialist Heart Failure Dietician
• Roy Yip– Specialist Heart Failure Occupational Therapist

Administrators

• Robert Nichol – Heart Failure Consultants Secretary
• Belmira Fernandes – Heart Failure administrator
• Ambreen Mawjee – Heart Failure Care Pathway Co-ordinator