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Op-Ed Ciara Cahill Cardiology CNS

People diagnosed with heart failure can maintain a high quality of life for longer with the support of the specialist clinics in UHL, Ennis and Nenagh and nurse specialists working in hospitals and in the community, writes Ciara Cahill, Clinical Nurse Specialist, Cardiology, University Hospital Limerick

Although heart failure can sound frightening, it is important that patients understand their heart is not about to stop.

Heart failure describes a heart that is not working as well as it should and can affect people of any age.

It occurs when the heart cannot pump enough blood around the body, as the walls of the heart become too weak or too stiff to work properly. It is estimated that 90,000 people live with the condition in Ireland. At University Hospital Limerick, our Heart Failure Service has an active list of 460 patients.

As we mark Heart Failure Awareness Week (May 1st- 7th), it is important to know what signs to look out for. The most common symptoms of heart failure include fatigue; shortness of breath, especially with activity or when lying flat; swollen feet, ankles or abdomen; and weight gain over a short period of time. Others may include loss of appetite; dizziness or near fainting episodes; rapid heartbeat; changes in mood or a reduced ability to exercise.

Symptoms like these happen when your heart is not pumping blood around the body efficiently, allowing excess fluid to pool in your lungs and elsewhere in your body, most usually your feet and ankles.

However, it’s important to note that heart failure can be prevented. Reducing your risk factors for heart disease will help prevent heart failure, such as not smoking, controlling high blood pressure, eating healthy food, maintaining a healthy weight, staying physically active and drinking moderately.

Heart failure generally responds very well to a combination of medicines and lifestyle changes. Some people may need operations, pacemakers or similar devices. With modern treatment, people with heart failure can lead long, quality lives.

For those in the Mid-West diagnosed with heart failure, it can be a very daunting prospect. However, the Heart Units within UL Hospitals Group – at UHL, Nenagh and Ennis - are here to support you.

Last year, the Heart Unit at UHL facilitated over 2,500 outpatient appointments. Of those, approximately 1,500 were review appointments of patients known to our service and a further 100 were new patients enrolled. Thankfully, we are recovering from the disruptive Covid-19 pandemic, and in the first quarter of 2023 our service in UHL has already seen 50 new patients through our clinics and 800 review appointments.

The Heart Unit at UHL is a nurse-led clinic. We have a team of five heart failure clinical nurse specialists (CNSs) who work under the governance of Dr. Samer Arnous, Clinical Lead for Cardiology, and his consultant colleagues.

A heart failure clinical nurse specialist is a nurse with additional specialist clinical training in heart failure. We are key members of the patient care team and central to helping people live well with heart failure.

We offer a flexible approach to our clinical care, facilitating clinics for our younger patients before they go to work and often late morning appointments for our older patients for whom attending appointments may be more challenging.

One of the primary aims of our clinic is admission avoidance, keeping our patients well in the community and avoiding the need for hospital admission. As a result, we often review patients on a weekly basis, or more often if required, in the event the patient may be suffering the early signs of deterioration.

We are also forging alliances with heart failure clinical nurse specialists working in the community aligned with the Slaintecare programme, the National Heart Programme and the Heart Failure Model of Care 2021.