Focus on current issues of heart failure

Meeting at the Ministry of Health of the Republic of Lithuania Dedicated to World Heart Failure Day

This year, the Ministry of Health of the Republic of Lithuania focuses on increasing the competence and responsibility of nurses.

The European Heart Failure Association recommends involving specialized nurses in a multidisciplinary team as an integral part of effective care for patients with heart failure.

In early February, Minister of Health Rimantė Šalaševičiūtė led a delegation to Linköping University Hospital in Sweden. The delegation included Prof. Aleksandras Laucevičius, the chief specialist in cardiovascular diseases in Lithuania; Dr. Jelena Čelutkienė, cardiologist and chair of the Heart Failure Working Group of the Lithuanian Society of Cardiology; Edita Lycholip, chief nurse and nursing administrator from Vilnius University Hospital Santaros Klinikos; and Dalia Guobužienė, Minister of Health advisor. They visited to learn about the structure of the heart failure clinic, the principles of multidisciplinary team work, and the role of nurses in caring for patients with heart failure.

Dr. Magnus Janzon, Head of the Cardiology Department; Dr. Peter Wodlin, Head of the Heart Failure Unit; and Anna Stromberg, RN, PhD, nursing professor, briefed our delegation on the main principles of the hospital's organization. They discussed how to adapt the longstanding positive experience and the need for heart failure clinics to Lithuanian healthcare institutions.

Heart Failure Association Congress in Seville

A record number of 4,790 participants gathered at the European Heart Failure Association Congress in Seville, Spain, this spring. One of the main topics of the congress was acute heart failure, which often leads to the hospitalization of patients and still carries a high risk of repeated hospitalizations and death shortly after discharge.

The congress published a significant document - the recommendations for the hospital and prehospital management of acute heart failure. Three societies adopted these recommendations by consensus: the European Heart Failure Association, the European Society of Emergency Medicine, and the American Academy of Emergency Medicine.

One new aspect of this document is minimizing the time to treatment initiation, similar to acute vascular occlusion conditions where every minute is crucial for better outcomes. Evaluating the early severity of the patient's condition, the recommendations advise actively involving nurses in this process. They also include indications for oxygen therapy and pulmonary ventilation and criteria for hospitalization in the intensive care unit or discharge home.

The document emphasizes starting treatment as soon as the patient arrives and performing diagnostic tests promptly. For hemodynamically stable patients, it suggests performing an echocardiogram as soon as possible and immediately testing natriuretic peptides, troponin, urine, creatinine, electrolytes, glucose concentration, and a complete blood count for all gasping patients.

In cases of respiratory failure, begin non-invasive pulmonary ventilation as early as possible. It is important to consult such a patient in an outpatient setting a few days after discharge and include them in the disease management program. Within one week, they should visit their family doctor and within two weeks, a cardiologist.