Heart Failure Specialist Nurses (HFSNs) now work in the community alongside their general practice colleagues. They can act as a valuable resource to support the primary care team in the management of heart failure patients. They carry out home visits and run community clinics to stabilise patients after discharge from hospital following an acute event. The aim is to educate patients and their family carers how to manage living with heart failure, up-titrate medications to optimal levels, stabilise the patient and then hand them back to the care of the primary care team, knowing that they will be referred back to the HFSN should their condition deteriorate. However, some complex patients with advanced heart failure (NYHA III or IV) and at high risk of re-hospitalisation are retained in the specialist nurse caseload.
A case of severe aortic stenosis
Cardiovascular risk management series: 2 – Using guidelines as a framework for cardiovascular risk management
Reducing the impact of vascular disease: the proposed Vascular Risk Programme for risk assessment and management
Measurement of baseline total cholesterol: new data from The Health Improvement Network (THIN) database
Ambulatory ECG monitoring in primary care
Cardiac arrhythmia affects more than 700,000 people in England and is consistently in the top ten reasons for hospital admission, consuming significant accident and emergency time and bed days.1 In the general population, arrhythmias are normally quite minor, silent, and typically benign. Symptoms may affect the patient enough to be both disruptive and distressful. In […]
The HYVET study: answering the question of whether or not to treat hypertension in the very elderly
Statin therapy for secondary prevention of coronary heart disease: an update (part 2)
The metabolic syndrome: myth or clinically useful marker?
The European perspective
Leave nothing to chance
Warfarin for atrial fibrillation: ‘faff’ or lifesaver?
Improving the management and prevention of stroke is a priority for the NHS. Atrial fibrillation (AF) is widely recognised to be a major cause of stroke. Moreover, it is a preventable cause in that the increased risk of stroke associated with AF can be markedly reduced by anticoagulation with warfarin. Yet a substantial number of cases of AF remain undetected and untreated. Of more concern, even after identification of AF, many individuals at high risk of stroke do not receive warfarin. This article reviews the evidence on the importance of AF as a cause of stroke and assesses the benefits of anticoagulation and our reluctance to anticoagulate. Finally, it explores ways of improving on current practice, to increase the proportion of patients with AF receiving anticoagulants.
