Pumping Marvellous

Reaching a diagnosis of heart failure typically involves several steps, including symptom recognition, BEAT and a simple blood test (NT-proBNP). These are the usual first steps to an initial assessment.

Heart failure is a syndrome that serves as an umbrella term for problems related to the heart’s function or its pumping action.

Heart failure can be caused by many different conditions, either on their own or together; these are known as co-morbidities.

Certain conditions increase your risk of being diagnosed with heart failure. These include a previous heart attack, high blood pressure, obesity, diabetes, heart rhythm disorders, cardiomyopathies, faulty heart valves, viral infections, and congenital heart disease, among other main causes.

• It is important to recognise the potential signs and symptoms of heart failure. The most common symptoms are breathlessness, along with fatigue, especially during exertion, and peripheral oedema (typically fluid retention in the feet, ankles, and legs). Recognising these symptoms should prompt your GP to order an NT-proBNP test, which measures the levels of a specific peptide in your blood. In the UK, if the levels are: –
• Below 400 – It is unlikely to be heart failure
• 400 -2000 – You should be referred to see a heart failure specialist within 6 weeks of the results of the blood test (assessment will include an echocardiogram)
• Over 2000 – Urgent referral to see a heart failure specialist within 2 weeks (assessment will consist of an echocardiogram)

An echocardiogram (“echo”) is a type of ultrasound scan of the heart. In some cases, you may also have an MRI scan alongside an echo.

A diagnosis of heart failure is made by a Cardiologist with a special interest in heart failure who will be part of your multidisciplinary team (typically including heart failure specialist nurses, a pharmacist, your GP, a cardiac rehab specialist, and other specialists where indicated). They will use your medical history, recent blood test results, electrocardiogram (ECG) readings, echocardiogram (Echo), and Magnetic Resonance Imaging (MRI), among other tests, to confirm or rule out the diagnosis of heart failure and to develop a treatment plan.