What do the new ESC guidelines actually mean for people living with heart failure?
In this episode of Beatwise The Podcast, I speak with heart failure nurse Becky Hyland, chair of the British Society for Heart Failure Nurse Forum, about how updated European Society of Cardiology guidelines should translate into everyday care in the UK.
We explore changes to heart failure definitions and staging, and why recognising people at risk could help shift services towards prevention and earlier diagnosis. We also discuss foundational medical therapy, including MRAs and finerenone, and the practical challenges of getting treatments to the patients who could benefit. But a recommendation is only useful if we can put it into practice.
Becky shares her perspective on the barriers facing heart failure services, from commissioning and workforce pressures to prescribing and follow-up. We discuss who checks blood results, who adjusts medication, and who patients can contact when they need support.
We also explore why a heart failure diagnosis should be the beginning of the investigation. Understanding the underlying cause - whether coronary artery disease, valve disease, an inherited condition or cardiac amyloidosis - can make a difference to the treatment offered.
Finally, we discuss when to consider devices and valve interventions, recognising advanced heart failure earlier, and how specialist referral and palliative care can support patients and their families. Throughout the conversation, we return to the importance of working together and ensuring that patients are involved in decisions about their care.
Key issues addressed:
EPISODE HIGHLIGHTS:
00:00 What Do the New Guidelines Mean for Heart Failure Care?
02:19 Changes to Ejection Fraction Categories and Heart Failure Stages
04:37 Prevention, Earlier Diagnosis and Teamworking
08:47 Foundational Medical Therapy and MRAs
11:28 Blood Tests, Medication Monitoring and Follow-Up
16:16 Why We Need to Find the Cause of Heart Failure
17:25 Imaging, Genetics and Amyloidosis
21:08 Devices and Heart Valve Interventions
25:47 Recognising Advanced Heart Failure and Referring Earlier
30:51 UK Priorities: Workforce, Shared Pathways and Education
35:18 Where Are the Gaps in Your Heart Failure Service?
38:31 Closing Thoughts
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