Thursday, March 3, 2016

Heart failure in need of increased services

CLOSER LOOK: Border Heart Specialist Cardiologist Dr Kugan Nadarasa wants to see a specialised clinic on the Border. Picture: ELENOR TEDENBORG
The Border MailBy Ellen Ebsary-Feb. 28, 2016
An Albury cardiologist wants to see a specialised clinic on the Border solely dedicated to heart failure.
Border Heart Specialist’s Doctor Kugan Nadarasa said an increased services was crucial to bringing down rates of hospitalisation.
“The hospital admission rate is very high, they will go again and again – so if we want to cut down the cause we have to prevent admission,” he said.
“If you want to prevent admission, you have to manage them properly before they develop acute heart failure.
“A multi-disciplinary team includes a specialist nurse trained in managing heart failure patients and a specialist looking after the echocardiogram.
“There’s a rehab nurse, a lot of psychology involved with the patients, and dietitians and a exercise physiologist.
“We know that multi-disciplinary team management improves their outcomes.
“There should be a heart failure clinic somewhere that patients can access.”
“We know that in tertiary centres the optimisation of evidence-based is much better compared to regional centres,” he said.

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Dr Nadarasa’s call for better services comes after the NSW Heart Failure Snapshot Study analysing 24 hospitals found important medication was not being used to full potential.
“For heart failure, it’s well established over the last 20 years, medical therapies are important,” Dr Nadarasa said.
“Even though your heart muscle is damaged, there are medications confirmed, as established in prospective studies, that will improve not only symptoms, but also lifespan.
“Topping the list is ARB blockers.
“Ever patient should be on ARBs, but as you can see in the study there are under-utilised.
“It’s not only they should be on them, but they need to be on a maximum dose so that we get maximum benefit.”
Heart Foundation chief executive Kerry Doyle said the study provided evidence to push for better treatment.
“Despite significant advances, prevalence of chronic heart failure remains high and clinical outcomes are poor,” Ms Doyle said.
“With funding from the NSW Cardiovascular Research Network, these findings can be used to develop strategies that are more responsive to improving access and increasing the uptake of evidence-based care.”
Dr Nadarasa said prevention was most important and urged residents to look out for symptoms.
“If you have chest pain, shortness of breath or leg swelling, those are the early signs of significant heart issues and you should go and see your doctor,” he said.