Morriston Hospital first in Wales to launch rapid form of treatment for heart failure

A husband and dad who feared heart failure would force him to give up work has become the first in Wales to see his life transformed by a new form of treatment.

Andrew Lewis felt so ill he ended up in the Emergency Department in Morriston Hospital and spent more than a week on a ward there.

Previously, the 56-year-old could not walk upstairs without struggling for breath. He was off work for two months and was facing up to the possibility of not being able to return.

Now the married dad of two from Pontarddulais, near Swansea, is feeling great, enjoying walking again and not just back in work but putting in extra hours to cover for an absent colleague.

“I can’t believe the turnaround,” said Andrew, who now only has to take five tablets a day. “I started feeling better straight away. It’s amazing what some tablets can do.”

Main photo above shows Dr Parin Shah.

Heart failure is a long-term condition where the heart function is impaired and unable to adequately pump blood around the body.

It can be caused by a number of problems including heart attacks, high blood pressure and arrhythmias.

While it can occur at any age, it is more common in older people. Heart failure cannot be cured but symptoms can be controlled and prognosis improved with optimal treatment.

Now an innovative new and improved treatment strategy for eligible patients is available at Morriston Hospital, the only site in Wales and one of just three in the UK to introduce it.

It could potentially benefit around 500 people, or 10 per cent of all heart failure patients in the Swansea and Neath Port Talbot areas.

Research has shown it will lead to a faster improvement in quality of life for eligible patients and could help reduce pressure on NHS services.

Traditionally, it can take up to six months or even longer to initiate and optimise therapies for heart failure patients.

However, an international study called STRONG-HF showed that early and quicker increases in doses of medication reduced symptoms and hospital readmissions.

Swansea Bay has been working in partnership with Roche Diagnostics to adopt the groundbreaking new treatment strategy, which has been endorsed by the European Society of Cardiology.

Morriston Hospital-based Dr Parin Shah, a cardiology consultant specialising in heart failure, said: “The medications used are quite powerful.

“They help the heart tremendously, but they affect the patient’s blood pressure and their kidney function, which could cause problems in optimising the treatment.

“Hence the guidance, until recently, was to take a slow approach to optimising the treatment for heart failure which could take six months or longer.

“However, STRONG-HF has shown that it is not only safe to optimise medications within six to 10 weeks but provides rapid symptom benefit to patients.

“Not everyone will be eligible for this. Some people may not be able to tolerate such intensive treatment. We knew it would be suitable for relatively few people, but it would benefit them considerably.”

Dr Shah said the heart failure nurses were involved in their direct care, helping them through their inpatient journey, supporting them at discharge and educating them about their heart condition.

“And then they are seen in the community by the community heart failure pharmacists or nurses who optimise their treatment in those six to 10 weeks rather than six to 10 months,” he added.

Andrew had not been well for several months by the time he arrived in the Emergency Department last November.

“I had swelling of the legs and feet and fluid around my midriff. They found out while I was in ED that I not only had fluid around my lungs but in my lungs,” he said.

“I was in hospital for around 10 days, having medication including a diuretic to get rid of the fluids as best they could, to give my heart the chance to work properly again.

“When I came home in early December they asked if I wanted to go on this fast-track system. I said yes, if it makes me feel better quicker and there’s no real risk of making me worse.”

Pictured right: Andrew with youngest son William.

Andrew had weekly appointments either with Dr Shah or with the pharmacist at Gorseinon Hospital. He will be undergoing further tests to try to identify the cause of his heart failure.

Meanwhile he’s enjoying life and his job with local company John Rickard Motor Factors. He said: “I did consider the possibility that I’d have to give up work. I had never been off more than two or three days in a row before, so it was definitely in the back of my mind.

“I was back in work when work started back in the New Year. As it happens, somebody else has been on long-term sick, so I’ve been doing five-and-a-half day weeks for most of that.

“Yes, I might feel a bit tired now and again but that was the norm anyway. Going back to the end of November, I could not have envisaged this. I’d had some good days and thought, what if I go back to work part-time? Let’s do a few hours in the morning.

“That’s what I had in mind. But the treatment and the tablets I’ve been on have made quite a difference. So yes, I am definitely glad I took part.”

Dr Shah said the service was proud to be among the earliest adopters of the new treatment strategy and enthusiastic about the improvements it could bring to patients’ quality of life.

“I’ve seen that these patients recover much faster, as STRONG-HF suggested,” he said. “And because we are seeing these patients more frequently, but in a shorter period of time, we are getting them through the system more quickly and hopefully that will free up capacity.”

Katherine Booth, Clinical Marketing Manager – Cardiac for Roche Diagnostics UK and Ireland, said: “We know this small but significant change to the management of heart failure could improve the lives of many patients.

“We are delighted to be working with Swansea Bay University Health Board on introducing this improvement. We hope to partner with more NHS organisations to ensure even more patients can benefit from it.”