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Heart Failure

Heart Failure

Heart failure (HF) is a complex disorder whereby the heart becomes progressively unable to pump blood efficiently to the tissues of the body. The Heart Failure Knowledge Centre focuses on the pathophysiology, diagnosis and management of chronic and post myocardial infarction (post-MI) heart failure.

Risk factors for ACS, and subsequently post-MI heart failure, are usually the clinical consequence of the formation of an occlusive thrombus at the site of a ruptured or eroded atherosclerotic plaque in a coronary artery. These can be modifiable (smoking,1 obesity,1 lack of exercise,1 hypertension,1,2 hyperlipidaemia,2,3 diabetes mellitus3) and non-modifiable (increased age1, male gender1, family history1,2) risk-factors.

The Heart Failure Knowledge Centre aims to provides healthcare professionals with the tools to diagnose and manage patients with both chronic and post-MI heart failure in line with current ESC guidelines.


References

  1. Kumar P, Clark M. Clinical medicine. 7th ed. Edinburgh: Saunders Elsevier, 2009.
  2. Graham I, Atar D, Borch-Johnsen K, et al. European guidelines on cardiovascular disease prevention in clinical practice: executive summary. Eur J Cardiovasc Prevent Rehab 2007;14 Suppl. 2:E1-40.
  3. Zeljko Reiner, Alberico L. Catapano, Guy De Backer et al. ESC/EAS Guidelines for the management of dyslipidaemias: The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J first published online June 28, 2011 doi:10.1093/eurheartj/ehr158.

Clinical Case Studies

Massive Pulmonary Embolism

Respiratory Medicine & Allergy: Pulmonary Vascular Diseases

Elizabeth Hadley, Consultant Respiratory and General Physician, Barking, Havering and Redbridge Hospitals University NHS Trust, London, UK
Christopher Kosky, Consultant Respiratory Physicians, Guy's and St Thomas' NHS Foundation Trust, London, UK

Case History
A 46-year-old Afro-Caribbean man presented to hospital after he collapsed with brief loss of consciousness. He was short of breath at rest and felt as if he couldn't take a breath in.

Sickle Cell Lung Disease

Respiratory Medicine & Allergy: Pulmonary Vascular Diseases

Elizabeth Hadley, Consultant Respiratory and General Physician, Barking, Havering and Redbridge Hospitals University NHS Trust, London, UK
Boris Lams, Consultant Respiratory Physicians, Guy's and St Thomas' NHS Foundation Trust, London, UK
Christopher Kosky, Consultant Respiratory Physicians, Guy's and St Thomas' NHS Foundation Trust, London, UK

Case History
A 40-year-old man with known homozygous (HbSS) sickle cell disease (SCD) presented to the emergency department with a three-day history of cough, fever and sweats. He denied any chest pain.

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Clinical Guidelines

Acute heart failure: diagnosing and managing acute heart failure in adults

Oct 2014

This guideline includes important aspects of the diagnosis and management of acute heart failure..

... that are not addressed by the NICE guideline on chronic heart failure (NICE clinical guideline 108). The guideline on chronic heart failure focused on long-term management rather than on the immediate care of someone who is acutely unwell as a result of heart failure.

This guideline covers the care of adults (aged 18 years or older) who have a diagnosis of acute heart failure, have possible acute heart failure, or are being investigated for acute heart failure. It includes the following key clinical areas:
- the role of early natriuretic peptide testing and echocardiography
- the role of specialist management units
- the use of ventilatory support, pharmacological therapy and ultrafiltration
- treatment after stabilisation, including selected surgical interventions and initiation of the pharmacological therapies that are used in the management of chronic heart failure.

2014 ESC Guidelines on the diagnosis and treatment of aortic diseases

Aug 2014

The ESC decided to publish updated guidelines on the diagnosis and treatment of aortic diseases..

... related to the thoracic and abdominal aorta. Emphasis is made on rapid and efficacious diagnostic strategies and therapeutic management, including the medical, endovascular, and surgical approaches, which are often combined. In addition, genetic disorders, congenital abnormalities, aortic aneurysms, and AD are discussed in more detail.

Online CME

Bradycardia: diagnostic picture tests

After completing this module you should be able to: describe the classification of bradycardias, describe the common causes of different types of bradycardia, and recognise typical electrocardiograms (ECGs).

Peripheral arterial disease: an update on management

On completion of this module you should know: The incidence and prevalence of peripheral arterial disease. How best to treat it. What information to give to patients about prognosis.

Stroke prevention in atrial fibrillation

On completion of this module you will understand more about: risk factors and screening, calculating risk, anticoagulation and falls and therapy.

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Renal Sympathetic Denervation by Iberis System in Patients With Uncontrolled Hypertension - Iberis-HTN Registry

Mon 17 Nov 2014

The purpose of this study is to document safety and efficacy of renal sympathetic denervation treatment in subjects with uncontrolled hypertension by using Iberis renal denervation ...

Cryoballoon Ablation in Patients With Longstanding Persistent Atrial Fibrillation (CRYO-LPAF)

Wed 12 Nov 2014

Prospective and explorative clinical study. The objective is to assess the clinical efficacy of pulmonary vein isolation using the Arctic Front Advance cryoballoon in patients with longstanding ...

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