Heart failure Resources

This case report explores the community management of a patient with a medical history of heart failure (HF) and oedema. Gold standard guidelines recommend targeting clinical congestion and oedema with increased loop diuretics alongside multilayer compression bandages for effective limb decongestion, reduction of swelling and limb shape restoration. Without early identification and intervention, oedema can worsen, leading to skin changes such as lymphorrhoea (wet or leaky legs), and having a detrimental physical, functional, and psycho-emotional impact on patients. Yet, HF and oedema continue to be mismanaged because healthcare workers have reservations about the use of compression therapy and concerns about overloading the circulatory system in patients with HF. This case report demonstrates appropriate treatment and management of oedema in patients with HF within a community district team setting, highlighting best guidance on diuretics, compression therapy, exercise, and skin care.

In the last 80 years, the number of people in the UK with diabetes has risen from 200,000 to over four million (Nazarko, 2023). People with diabetes have at least double the risk of heart failure than the general population (Kenny and Abel, 2019), with American research indicating that 22% of people who have diabetes have heart failure (Pop-Busui et al, 2022). Most cases of heart failure are diagnosed in hospital, although 40% of people with heart failure have symptoms that the British Heart Foundation (BHF, 2025) comment ‘should have triggered an earlier assessment’. This article examines the link between diabetes and heart failure to update nurses working in primary care on who is at risk, when to suspect heart failure, as well as how it is diagnosed and treated.

You might be surprised to learn that heart failure (HF) affects almost a million Brits, and that there are 200,000 new cases annually (British Heart Foundation — https://bit.ly/3LAxTlO). At Pumping Marvellous, the UK’s only dedicated patient-led heart failure charity, we are not surprised that you did not know that. HF’s profile is far lower than it should be, and people
— decision makers, public, policy makers, politicians — are reluctant to talk about HF.

Heart failure is a common chronic condition and people living with it can have periods of relative stability as well as episodes where their symptoms worsen and they require hospital admission and treatment (Chun et al, 2012), such as intravenous (IV) diuretics. Traditionally, patients who failed to respond to an increase in oral diuretics have been admitted to hospital for IV diuretics. The British Heart Foundation (BHF) funded a two-year project in 10 NHS organisations across the UK to determine if delivering IV diuretics in the patient’s home or in a community􀀃 by patients and carers (BHF, 2014).The programme was led by heart failure specialist nurses working within existing community heart failure teams and was built on existing evidence that, when compared to other heart failure patients, heart failure patients times less likely to be hospitalised (BHF, 2008). As IV diuretic services become embedded into existing services, community nurses have an important role to play in working in partnership with heart failure specialist nurses to support patients having􀀃 challenges of delivering IV diuretics in the home.