What is the aim of the clinic?

• explain your heart condition
• explain and review your heart medication
• review your health and symptoms related to your heart condition
• check your blood pressure, pulse and other readings
• give healthy living advice that could improve your heart condition
• review your medication regime and alter or introduce medication to improve your heart condition (this may take several appointments).

How many appointments will I need?

• this will vary according to the type of heart condition you have
• if you are seeing us because of a heart attack or heart surgery you will usually require one or two appointments
• if you are seeing us after an angioplasty or stent and wish to join a cardiac rehabilitation class you will usually require one appointment
• if you are seeing us because of a diagnosis of heart failure, we may need to alter your heart medication often. This might mean seeing us for a few weeks or months.

What if I am housebound?

We are able to visit people who are housebound but not everyone is eligible for this. The cardiac nurse can discuss this with you when they first contact you.

Our aim

The cardiac service offers high quality patient care, respecting individual wishes, beliefs and needs. This involves working closely with your hospital, GP and other services, as well as your family or carers. We help you maintain and improve your quality of life.

How can we help?

We are here to help you with your recovery following your recent heart attack or cardiac surgery. We understand this may be an anxious time for you and we want to support you in the best possible way.

We can:

• advise the safest way to resume physical activity
• discuss medication
• offer reassurance, advice and support to help you make positive lifestyle changes, such as giving up smoking, changing your diet or becoming more active
• provide expert individualised advice regarding modifying your risk factors for heart disease
• refer you to the Cardiac Activity Programme where appropriate.

Where do we see patients?

We offer appointments via telephone, video or face to face. Face to face appointments are offered in local health centres. We are able to visit people who are housebound but not everyone is eligible for this. The cardiac nurse can discuss this with you when they first contact you.

Aim of the service

The cardiac service offers high quality patient care, respecting individual wishes, beliefs and needs. This involves working closely with your hospital, GP and other services, as well as your family or carers. We help you maintain and improve your quality of life.

What is the heart failure nursing service?

We are a team of specialist nurses with broad nursing experience and specialised cardiac skills. We care for people who have already been diagnosed with heart failure with a reduced ejection fraction (HFrEF)

The team will:

• work closely with you, your GP and your hospital consultant to try and improve your symptoms and quality of life
• plan your care with you to meet your individual needs
• offer support and individualised advice for you and your family
• discuss and review your medication and adjust if necessary
• monitor your condition and blood tests as needed
• refer you to other services where appropriate
• we will transfer your care back to your GP once your condition is stable
• refer you to the Cardiac Activity Programme where appropriate.

What is heart failure?

Heart failure is a condition where the heart is unable to pump strongly enough to meet the body’s demands for blood and
oxygen.

The main causes of heart failure are:

• damage to the muscle caused by a heart attack
• high blood pressure
• heart valve disease.

The main symptoms of heart failure are:

• shortness of breath
• fluid retention, this could be swelling of the feet, ankles, legs and stomach
• tiredness.

Where are patients seen?

The service runs from local health centres across Leeds. These are:

• Armley Moor Health Centre
• Bramley Clinic
• Chapeltown Health Centre
• Kippax Health Centre
• Kirkstall Health Centre
• Meanwood Health Centre
• Morley Health Centre
• Pudsey Health Centre
• Seacroft Clinic
• Wetherby Health Centre
• Yeadon Health Centre
• Holt Park Health Centre
• East Leeds Health Centre
• Middleton Health Centre
• Rothwell Health Centre
• Hunslet Health Centre
• Park Side Health Centre
• Wharfedale General Hospital – Community Cardiac Clinic
• Halton Health Centre.

Housebound patients are seen at home by arrangement.

Frequently asked questions

How can diuretics be given?

The most common way to give diuretics is in tablet form (water tablet).
Sometimes the tablets do not work as well as they should and fluid can build up in your body.
Giving the diuretic by injection can be more effective. There are two ways of doing this:

1. Intravenously (IV): This is where a fine tube called a cannula is inserted into a vein and the diuretic is given by injection over a period of time (the period of time will depend on the dose given)
2. Subcutaneously (SC): This is where a small fine tube called a cannula is inserted under the skin and the diuretic is infused over 24 hours. Before a cannula is inserted the procedure will be explained and a sample shown to you first if you choose. This will be done by the nurse visiting you at home.

Do I need to be in hospital or can I be at home for my IV treatment?

This treatment was previously only offered in hospital but is now available as a community treatment for patients with heart failure.

Do I have to purchase anything?

No. The nurse will arrange and deliver everything needed to give you this treatment (unless you currently have to pay for your medical prescriptions in which case the usual prescription charge will apply). If you are being discharged from hospital on this treatment then a supply of the drug will be sent home with you.

Are there any risks to me if I receive treatment at home?

An allergic reaction to a drug may sometimes occur when a new drug is given, but this is rare (and you may have already safely received this treatment in hospital). You will be given advice about reactions and what to do if one occurs.
You may experience some side effects including dizziness. This is usually due to a drop in your blood pressure and must be reported to your nurse.
Diuretics can sometimes alter your kidney function. You will have regular blood tests at home to monitor this closely.

Can I bathe/shower?

You can still shower and bath so long as the line is kept clean and dry. The cannula should not be immersed in the bath. If the dressing does become wet underneath please tell your nurse when they arrive.

How is the cannula removed when it is no longer needed?

A nurse will remove the cannula. It will come out easily. A dry sterile dressing will be placed over the site if required. This can be removed after 24 hours.

Who will give me my IV medication?

A nurse will come to your home to insert the cannula, prescribe and administer your medication. You may decide that you prefer to have this treatment in hospital which can be arranged if necessary.

What if it does not work?

This will depend on your individual wishes. Your heart failure nurse may recommend that you are admitted to hospital or they may seek advice from the cardiologist. It may be that you are not well enough for any further hospital treatment and that you would prefer to stay at home or possibly the hospice – this would all be discussed with you by your heart failure nurse.

How can I help care for my cannula?

To prevent infection your cannula must be kept clean and dry. A dressing will cover the cannula site. Your cannula will be checked every day by your nurse. The cannula will normally need to be removed after three days and replaced if the treatment is still needed.
You should avoid heavy lifting and excessive movement of your arm to prevent the cannula from becoming dislodged.
Complications with cannulas are rare but please seek advice if you have any of the following problems with your cannula:

• Pain at the cannula site
• Redness, swelling or oozing at the cannula site
• If it becomes dislodged or falls out (in which case cover the site with the clean dressing provided and press firmly to stop any bleeding)

Otley and North Leeds Cardiac support group

For more information about this support group,

• Wharfedale Cardiac Club website
• Email: wghcardiacclub@gmail.com
• Phone: 07818 024059  or 07487 565070
• By post: Wharfedale Cardiac Club,
  c/o 410 Otley Road, Leeds LS16 8AD

Please do not post items directly to us at the Wharfedale Hospital)

Pulsations

What is the group all about?

We support cardiac patients and their relations through our phase 4 support group, we are a very friendly patient lead support group.

• Addres: Garden Village Welfare Hall, Pendas Way, Leeds, West Yorkshire, LS15 8LE
• Phone: Call Richard on 07791 909054