Heart Failure: Management of decompensation (Guidelines)

Warning

Audience

  • Highland HSCP
  • Primary and Secondary Care

Pathway

 

Education

  • Disease process
  • Fluid and weight management
  • Early warning signs (traffic lights)
  • Medication concordance
  • Cardiac rehabilitation
  • Immunisation
  • Social support

Cardiac devices

The choice of device will be decided by the cardiology team based on the following criteria:

Implantable Defibrillator (ICD) Primary Indications

  • QRS <130mms
  • Ejection fraction < 35% (equivalent to moderate/severe LVSD)

Cardiac Resynchronisation Therapy (CRT +/- D)

  • QRS >130mms
  • Ejection fraction <35% (equivalent to moderate/severe LVSD)

Referral to nurse led heart failure service

The Nurse Led Heart Failure Service provides a comprehensive care package for heart failure patients, working in partnership between primary and secondary care.

Referrals can be made by any member of the multidisciplinary team as long as the following criteria are met:

  • Patient must have documented evidence of heart failure due to left ventricular systolic dysfunction (LVSD) (either by echo, MUGA scan or angiogram).

Plus

  • Be symptomatic despite medical therapy

Or

  • Had a recent hospital admission due to heart failure

Ultimately- patient must be willing to be part of the service.

Benefits can include

  • Education- to detect early warning signs and symptoms and to enable self management
  • Medication optimization
  • On-going support for patient and carer
  • Palliative Care Support

For more details please contact your local Heart Failure Nurse or contact the main Heart Failure Office on 01463 704628 or email nhsh.heartfailureservice@nhs.scot

Patient name and CHI number needed for referrals.

Abbreviations

Abbreviation Meaning
ACE inhibitor Angiotensin-converting-enzyme inhibitors
ARB Angiotensin receptor blockers
ECG Electrocardiogram
LVSD Left ventricular systolic dysfunction
CHSS Chest, Heart and Stroke Scotland

Editorial Information

Last reviewed: 04/10/2023

Next review date: 31/10/2026

Author(s): Cardiology.

Version: 2

Approved By: TAMSG of the ADTC

Reviewer name(s): Prof Stephen Leslie, Consultant Cardiologist.

Document Id: TAM132

Related resources

Further information for Health Care Professionals

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References

Further information for Patients

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Self-management information