Practical Heart Failure Management in Primary Care

Aims / objectives

To develop participants’ knowledge, confidence and clinical decision-making skills in the recognition, assessment and management of adults with heart failure in primary care.

Learning Objectives

By the end of the course, participants will be able to:

• Describe the anatomy and physiology of the cardiovascular system in relation to heart failure.
• Explain the pathophysiology and classifications of heart failure.
• Recognise common signs and symptoms and undertake a structured clinical assessment.
• Differentiate heart failure from other common causes of breathlessness and oedema.
• Understand current pharmacological and non-pharmacological approaches to management.
• Identify the role of diagnostic investigations, including echocardiography.
• Recognise when referral, escalation or specialist intervention may be required.
• Explore end-of-life and palliative care considerations in advanced heart failure.
• Apply learning to practice through interactive case studies and workshop activities.

Course programme

Anatomy and Physiology (A&P)

• Review of cardiac anatomy and normal cardiovascular function.
• Cardiac output, preload, afterload and circulation.
• How the healthy heart functions.
• Compensatory mechanisms and the impact of dysfunction.

Pathophysiology of Heart Failure

• What is heart failure?
• Types of heart failure:
  • Heart Failure with Reduced Ejection Fraction (HFrEF)
  • Heart Failure with Preserved Ejection Fraction (HFpEF)
  • Heart Failure with Mildly Reduced Ejection Fraction (HFmrEF)
• Left versus right heart failure.
• Acute and chronic presentations.
• Common causes and precipitating factors.
• Disease progression and decompensation.

Epidemiology

• Incidence and prevalence within the UK.
• Risk factors and vulnerable populations.
• Multimorbidity and frailty.
• Impact on primary care services and hospital admissions.

Signs and Symptoms

Recognising early and advanced presentations:

• Breathlessness and fatigue.
• Orthopnoea and paroxysmal nocturnal dyspnoea.
• Peripheral oedema.
• Weight gain and fluid overload.
• Functional decline and reduced exercise tolerance.
• Red flag symptoms requiring escalation.

Clinical Assessment

A structured approach to assessing patients with suspected heart failure:

• Focused history taking.
• Symptom review and red flags.
• Medication review and concordance.
• Functional assessment and NYHA classification.
• Remote and face-to-face assessment considerations.
• Recognising clinical signs through video demonstration and image-based learning.
• Diagnostic investigations:
  • NT-proBNP
  • Blood tests
  • ECG
  • Chest X-ray
  • Echocardiography

Differential Diagnosis

Differentiating heart failure from other common presentations:

• COPD and asthma.
• Pneumonia.
• Anaemia.
• Chronic kidney disease.
• Venous insufficiency.
• Obesity and deconditioning.
• Anxiety and dysfunctional breathing.
• Medication-related oedema.

Heart Failure Management in Primary Care 
Pharmacological Approaches

Overview of evidence-based management:

• Diuretics and fluid management.
• ACE inhibitors and ARBs.
• ARNIs (sacubitril/valsartan).
• Beta blockers.
• Mineralocorticoid receptor antagonists.
• SGLT2 inhibitors.
• Medication optimisation and monitoring.
• Managing side effects and adherence.
• Supporting safe prescribing and escalation.

Non-Pharmacological Approaches

Supporting long-term management and self-care:

• Lifestyle advice.
• Fluid and salt management.
• Weight monitoring.
• Physical activity and rehabilitation.
• Smoking cessation and alcohol advice.
• Vaccination and infection prevention.
• Patient education and self-management.
• Supporting carers and psychosocial wellbeing.

Devices and Surgical Management

Understanding specialist interventions:

• Implantable cardioverter defibrillators (ICDs).
• Cardiac resynchronisation therapy (CRT).
• Pacemakers.
• Valve interventions.
• Revascularisation procedures.
• Heart transplantation overview.
• Referral pathways and when to escalate.

End-of-Life and Palliative Care

Supporting patients with advanced heart failure:

• Recognising advanced disease.
• Prognostic indicators.
• Advance care planning.
• Difficult conversations.
• Symptom management.
• Community support and multidisciplinary care.
• Supporting families and carers.

Echocardiography (Echo)

Understanding echo reports in primary care:

• What is echocardiography?
• Understanding ejection fraction.
• Systolic and diastolic dysfunction.
• Valve abnormalities.
• Common terminology used in reports.
• Recognising findings relevant to practice.

Interactive Workshop – Applying Learning to Practice

Bringing theory into practice through facilitated virtual workshops:

• Heart failure case studies.
• Clinical assessment exercises.
• Differential diagnosis challenges.
• Medication optimisation scenarios.
• Interpreting investigations and echo findings.
• Escalation and referral decisions.
• Group discussion and reflective learning.

Led by

TBA

Participant Voices!

FM, Practice Nurse "Excellent course with a really practical focus. I now feel much more confident recognising early signs of heart failure and understanding when to escalate concerns or refer appropriately."

HW, Practice Nurse "The session on echocardiography was particularly useful. I have always found echo reports difficult to interpret, but the explanations made them much easier to understand and apply in practice."

 SB District Nurse "Very relevant to care in the community. The case studies and medication discussions helped me better understand newer treatments and how to support patients with long-term management."

PR, Practice Nurse "An engaging and informative course delivered at the right level. It brought together assessment, diagnosis and management in a way that felt directly applicable to everyday consultations."