Free, independent CPD for Irish doctors by Irish doctors

Heart Failure

By

• Prof Ken McDonald

Reviewed by: Dawn O'Shea

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About this Module

More than 10,000 new cases of heart failure are diagnosed in Ireland every year, yet the majority are still diagnosed via hospital admission. Despite its prevalence, heart failure remains a challenging condition to identify early due to non-specific symptoms like fatigue and breathlessness, which are often mistakenly attributed to aging.

In this episode, host Dawn O’Shea is joined by Professor Ken McDonald, Consultant Cardiologist at St. Vincent’s Hospital and National Co-Lead for the National Heart Program. Professor McDonald shares expert insights on the clinical “antennae” required to catch heart failure in the community, the critical role of natriuretic peptide testing, and the evolving landscape of disease-modifying therapies. He also addresses the integration of new treatments like SGLT2 inhibitors and the importance of structured patient self-care in long-term management.

5 Interesting Takeaways:

• The Diagnostic Delay Challenge: In the UK system, the time from the onset of symptoms to a formal diagnosis of heart failure can exceed two years—a delay that would be considered unacceptable in cancer care.
• The Power of Rule-Out Tests: Natriuretic peptide is an exceptional “rule-out” tool; if the test is normal, practitioners can be very confident the cause of breathlessness is not heart failure.
• The “Homegrown” Diuretic Effect: Certain disease-modifying treatments, such as the ARNI compound (sacubitril/valsartan), can reduce a patient’s need for traditional diuretics by preserving the body’s own natural atrial natriuretic peptide.
• SGLT2 Inhibitors’ Amazing Evolution: Originally developed for type 2 diabetes, SGLT2 inhibitors have emerged as a cornerstone of heart failure therapy for both reduced and preserved ejection fraction, even in patients without diabetes.
• The Importance of Reaction Over Detection: Advanced monitoring technology is only effective if there is a system to react to the data; many hospitalizations could be avoided if patients and providers acted more quickly on early signals like sudden weight gain or worsening fatigue.

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Module Steps

To earn CME credit, follow these steps:

• Listen to the podcast.
• Complete the 5 MCQs that follow. After each question, you will be able to see whether you answered correctly and will then read evidence-based information that supports the most appropriate answer choice. These questions are part of the educational content and are designed to challenge you. You will not be penalised for answering the questions incorrectly.
• Complete the 10 True or False questions in the Post-Module Assessment. These questions are designed to demonstrate that the module has improved your knowledge base on this topic.
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To successfully earn credit, participants must complete the activity online, and receive a minimum score of 70% on the post-module assessment.