Pumping Marvellous

Heart failure is a syndrome which means that it is an umbrella term used to describe problems with the functioning of the heart or problems with the pumping action of the heart.

Heart failure can be caused by many different conditions, either as individual or multiple conditions, these are called co-morbidities.

Getting to the point where a heart failure diagnosis is made usually takes several steps, however one simple blood test (NT-proBNP) is usually the first test.

There are certain conditions that increase your chances of being diagnosed with heart failure. These include a previous heart attack, high blood pressure, diabetes, heart rhythm problems, cardiomyopathy, faulty heart valves, certain viral infections, and congenital heart disease to name some of the main causes.

It is important to recognise the potential signs and symptoms of heart failure. . The most usual symptoms are breathlessness, combined with fatigue especially on exertion and peripheral oedema (typically fluid retention in the feet, ankles, and legs). Recognising these symptoms should warrant your GP to order an NT-proBNP test which measures the levels of a certain 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 include an echocardiogram)

An echocardiogram (“echo”) is an ultrasound scan of the heart. In certain circumstances you may have an MRI scan in addition to 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 multi-disciplinary team (typically including heart failure specialist nurses, pharmacist, your GP, cardiac rehab specialist and other specialists where indicated). They will use your medical history, recent blood test results, electrocardiogram (ECG) readings and echocardiogram (Echo) and Magnetic resonance imaging (MRI) amongst others to confirm or refute the diagnosis of heart failure and also draw up a treatment plan.