80% of heart failure diagnosed in A&E, cardiology nurse warns

Nurse Mairead Lehane says that early diagnosis and timely treatment of heart failure can prevent prolonged hospitalisation.

An estimated 90,000 people have undiagnosed heart failure, with many only discovering the potentially serious condition in a hospital emergency department, a Cork cardiology nurse has warned.

A further 90,000 have this condition, which left untreated can be as deadly as some cancers, according to Mairead Lehane, who is an advanced nurse practitioner in cardiology (integrated care) at Cork University Hospital and the Cork city Chronic Disease Hub.

“In 80% of cases, heart failure is diagnosed in the accident and emergency department or in the GP surgery when people become acutely unwell,” she said.

“Often, patients have been experiencing symptoms for some time so early detection has big advantages for the patient experience. An early diagnosis and timely treatment can prevent an urgent trip to the emergency department and a prolonged hospitalisation.” 

She said that while people are often aware of the signs of a heart attack, there is less knowledge about heart failure.

A heart attack is a blockage of the coronary arteries — essentially a plumbing problem — whereas heart failure is a problem with the pumping power of the heart

This can mean “the heart muscle it is too weak to pump properly”, which can sometimes occur after a heart attack or prolonged high blood pressure or it can mean “the heart is too stiff to fill properly”, she said.

Ms Lehane, who is currently the president of the Irish Association of Heart Failure Nurses, described the condition as common and “affecting 90,000 of the Irish population, with 90,000 undiagnosed living in the community.” 

While it is more common among older people, she cautioned that "it is a condition that can affect anyone at any age”.

An awareness of the risk factors including high blood pressure, obesity, and high cholesterol are a hugely important. Eating two or more servings of avocado every week cuts the risk of heart disease by a fifth, according to a new study

Rates of the disease are predicted to rise across Europe, with the latest estimate for Britain a doubling of heart failure rates by 2040.

“An awareness of risk factors such as high blood pressure, high alcohol intake, obesity, lack of physical fitness or inactivity, poorly controlled diabetes, high cholesterol, valve disease or abnormal heart rhythms are hugely important,” she urged.

Our main message is the importance of early detection.

The association is supporting a #BumpUpThePump campaign to boost public awareness.

“Anyone concerned about symptoms of heart failure please contact your GP for an assessment,” she said.

“Ask about the NTProBNP test. There is only one failure in heart failure and that is failure to act.

"Do not delay seeking help if you experience breathlessness, fatigue, or leg swelling. The earlier you are diagnosed, the earlier treatment may begin which will increase your chance of better outcomes.” 

Ms Lehane also pointed to changes in how heart failure is being treated in Cork. This is linked to the Sláintecare plans including for patients to get chronic disease care outside of hospitals.

“Chronic disease management is improving in Ireland,” she said.

“The development of Integrated Care Hubs nationally and locally in Ballincollig, Gurranabraher, Mallow and Kerry means care is available closer to the patient.” 

There are also plans for a clinic in Bantry in the future, she added.