Heart failure- NICE guideline

This video makes reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". Please note that the content on this channel reflects my professional interpretation/summary of the guidance and that I am in no way affiliated with, employed by or funded/sponsored by NICE.
My name is Fernando Florido and I am a GP in the United Kingdom. In this video I go through the NICE guidelines “Chronic heart failure in adults: diagnosis and management” or NG106, Published on 12 September 2018
There is a podcast version of this and other videos that you can access here:
Primary Care guidelines podcast:
• Redcircle: redcircle.com/shows/primary-c...
• Spotify: open.spotify.com/show/5BmqS0O...
• Apple podcasts: podcasts.apple.com/gb/podcast...
Diabetes in Primary Care podcast:
• Redcircle: redcircle.com/shows/diabetes-...
• Spotify: open.spotify.com/show/5BmqS0O...
• Apple podcasts: podcasts.apple.com/us/podcast...
The NICE guideline on chronic heart failure can be found here:
• Website: www.nice.org.uk/guidance/ng10... or as PDF: www.nice.org.uk/guidance/ng10...
• Or download here: 1drv.ms/b/s!AiVFJ_Uoigq0lgl6i...
The NICE recommendations on dapaglifozin and empaglifozin in HF can be found:
• On website here:
o Dapaglifozin in HF: www.nice.org.uk/guidance/ta679 or www.nice.org.uk/guidance/ta67...
o Empaglifozin in HF: www.nice.org.uk/guidance/ta773 or www.nice.org.uk/guidance/ta77...
• Or downloaded here:
o Dapaglifozin: 1drv.ms/b/s!AiVFJ_Uoigq0lgfx8...
o Empaglifozin: 1drv.ms/b/s!AiVFJ_Uoigq0lggUB...
The Visual summaries on diagnosis and management of heart failure can be found here:
• Website:
o Diagnosis: www.nice.org.uk/guidance/ng10...
o Management: www.nice.org.uk/guidance/ng10...
• Or download here:
o Diagnosis: 1drv.ms/b/s!AiVFJ_Uoigq0lgW9d...
o Management: 1drv.ms/b/s!AiVFJ_Uoigq0lgZLG...

[@darkmoon3646]

Keep adding more nice guidelines! Youre doing an amazing job, thankyou❤

[@practicalgp]

Thank you very much for the encouragement. I will do . Sometimes life gets in the way and the frequency of the episodes suffers as a result

[@Katlady-rs4eg]

Excellent information!

[@practicalgp]

Thank you very much for your comment. I really appreciate it 🙏

[@user-gy8cn3mt2h]

Thanks. Excellent information

[@practicalgp]

Thank you for your comment, I really appreciate it 🙏

[@sumas5707]

Thank you for the information sir

[@practicalgp]

Not at all, I’m pleased that you found it useful

[@TruthfulPromise]

Very useful. Please make more videos. Thank you.

[@practicalgp]

Thank you for your support. It means a lot 🙏

[@touseefbeig915]

Thank you

[@practicalgp]

Thank you for saying that. I really appreciate it.

[@user-zu4pn8kk7u]

Wow , I just chanced on this channel of yours and I was so amazed at the level of details and information. I quickly subscribed , I am in Africa and really your videos. Will forever follow for more videos

[@practicalgp]

Thank you very much for your comment. I really appreciate it. This video kzbin.info/www/bejne/qmOucqKaqKanhLMsi=RvIdwvveApAhtspQ reinforces some of the heart failure concepts and other people have found it useful especially in terms of distinguishing between the management of HFpEF and HFrEF 👍

[@user-zu4pn8kk7u]

@@practicalgp Thanks so much once again. Have recommended it to my other colleagues.

[@practicalgp]

@@user-zu4pn8kk7u Many thanks to you! Would you mind telling me where in Africa you are?

[@reshminair3056]

Thank you for the extra information about sacubitril valsartan at the end. 😊

[@practicalgp]

Thank you for your comment. I am pleased that you found that bit interesting. I find pathophysiology very intriguing and I could not resist mentioning it, even though it is not strictly speaking NICE guidance. I will be doing something on heart failure again soon so stay tuned!

[@reshminair3056]

​@@practicalgp - Yes Sir, it really helps especially in the long run. If one knows the logic behind it they will retain the information forever rather than just reading it. Looking forward for the upcoming episodes 😊.

[@practicalgp]

True, clinical presentations are easier to remember than a list of symptoms followed by a protocol 👍

[@mindcache5650]

A shocker . The U.S and Canada after extensive clinical trials now put SGLT2 inhibitors right at the top and central to all treatments.

[@practicalgp]

More like welcome good news! 😁

[@fredbloggs8816]

Excellent but no focus on HF with preserved EF or did I miss it?

[@practicalgp]

Thank you for your comment. The issue is that NICE does not have a specific section on the management of HFpEF. Instead, they put the management of HFpEF under the management of “all types of heart failure”. This is because HFpEF does not have any specific treatment other than the symptomatic relief with diuretics (although recently NICE updated the guidance recommending dapagliflozin as an option). It is easier to understand on a practical case and perhaps I explain it better in another one of my videos: kzbin.info/www/bejne/qmOucqKaqKanhLMsi=_a0qCLieuJKpNrox . Here I explain in more detail the rationale of the HF management even before we know the patient’s type of heart failure. If you do not want to go through the initial discussion, you can fast forward to minute 10.38 where I start talking about the management. I hope that this helps.

[@fredbloggs8816]

Hello @@practicalgp - will be looking at your other video and many thanks for your reply.

[@johnspillman5403]

Just add the only one who look after me, is me, weight and blood pressure every morning 🙏 amituofu

[@practicalgp]

Thank you for your comment. It’s true that managing weight and blood pressure correctly is paramount, and the individual person is best placed to look after themselves. Keep persevering!👏💪

[@johnspillman5403]

@@practicalgp my heart failure was caused by have a 2 lead pacemaker fitted, for AF that did not stop the AF and after AV node ablations to fit the pacemaker cause ventricular dyssynchrony in to heart failure This is always the same for me when consultants treat me as nominal patient, am not my physiology is difficult because of hypermobily ehlers-danlos syndrome, I have had many orthopaedic operations that where not a success because of Lex collagen not just in joints, as GP I would you to be mindful of people as patient that my have ehlers-danlos syndrome there 13 different type and so overlap, it more common than you my think because it go's undiagnosed, my AF my have been cause by a lack of magnesium or B12 or both, one of things to check first with AF I believe would be good 🙏 amituofu

[@practicalgp]

I’m sorry that you have had all these complications. I hope that things improve for you

[@jackiemuthafuckenoh4800]

The doctors where I'm from are not this explanatory. Since diagnosed in 8/19 I've been in the dark about hf. Watching your video , im actually starting to understand it a lil better. I've been referring to google and fb groups and self research and just getting more confused. I wish my doctors were as explanatory as you are it starting to make sence... by the time they figure it out, it will probably be too late for me😭

[@practicalgp]

Thank you for your comment. I’m pleased that you have found it useful. It’s intended for healthcare professionals so it may have got a little technical at times. Please don’t despair. Keeping your spirits up is half the battle 🙏