Heart Failure Service
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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
- Medications. 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.
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 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 Xrays.
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.
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.
Ambulatory Heart Failure Clinic
This is a nurse led clinic for patients with heart failure in the community who require intravenous (injections) of diuretics to help get rid of excess fluid (which is a common symptom in heart failure). This reduces the need for inpatient admissions and patients can remain in the community.
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 echocardiograpy. 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.
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.
- Dr Lisa Anderson – Consultant Cardiologist
- Dr Nesan Shanmugam – Consultant Cardiologist
- Dr Robin Ray – Consultant Cardiologist
- Dr Rajay Narain
- Dr Rajay Narain – Senior Heart Failure Fellow
- Dr Soraya Khaki – Clinical fellow
Specialist Heart Failure Nurses
- Matthew Sunter
- Catriona Schwendtner
- Siobhan Armstrong
- Sinead Lyons
- Jolanta Stwora-Fuah
- Jane Nokes – Ward Manager, Heart Failure Unit.
- Susan Eriksen – Highly specialised physiotherapist in heart failure.
- Rebecca Jones – Specialist heart failure dietician
- Diedre O’Riordan– occupational therapist
- Robert Nichol – Heart Failure Consultants secretary
- Aiste Povilaityte – Heart Failure administrator
- Luke D’Urban Burgess – Heart Failure data administrator
- Carol Stechman – Heart Failure Care Pathway Co-ordinator
- Vennessa Sookhoo
- Sinead Lyons